Provider Demographics
NPI:1104045228
Name:HILLS & DALES GENERAL HOSPITAL, INC
Entity Type:Organization
Organization Name:HILLS & DALES GENERAL HOSPITAL, INC
Other - Org Name:HILLS & DALES AFTER HOURS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-912-6225
Mailing Address - Street 1:4675 HILL ST
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-1008
Mailing Address - Country:US
Mailing Address - Phone:989-912-6114
Mailing Address - Fax:989-912-6116
Practice Address - Street 1:4672 HILL ST
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-1028
Practice Address - Country:US
Practice Address - Phone:989-912-6114
Practice Address - Fax:989-872-1929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI231316Medicare Oscar/Certification