Provider Demographics
NPI:1154504892
Name:ASCENSION BORGESS HOSPITAL
Entity Type:Organization
Organization Name:ASCENSION BORGESS HOSPITAL
Other - Org Name:ASCENSION BORGESS - PIPP HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-226-4800
Mailing Address - Street 1:411 NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 NAOMI ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1222
Practice Address - Country:US
Practice Address - Phone:269-685-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BORGESS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-17
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI03-0031282E00000X
284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4586565Medicaid
MI232034Medicare PIN