Provider Demographics
NPI:1275932329
Name:STURGIS HOSPITAL, INC.
Entity Type:Organization
Organization Name:STURGIS HOSPITAL, INC.
Other - Org Name:COLON MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LABARGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-651-7824
Mailing Address - Street 1:916 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-2326
Mailing Address - Country:US
Mailing Address - Phone:269-651-7824
Mailing Address - Fax:
Practice Address - Street 1:111 S SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:COLON
Practice Address - State:MI
Practice Address - Zip Code:49040-9342
Practice Address - Country:US
Practice Address - Phone:269-432-3321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI238672Medicare Oscar/Certification
MI238929Medicare Oscar/Certification