Provider Demographics
NPI:1326120221
Name:MARQUETTE GENERAL HOSPITAL, INC
Entity Type:Organization
Organization Name:MARQUETTE GENERAL HOSPITAL, INC
Other - Org Name:MARQUETTE GENERAL HOME MEDICAL EQUIPMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-225-4718
Mailing Address - Street 1:580 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2705
Mailing Address - Country:US
Mailing Address - Phone:906-225-4718
Mailing Address - Fax:
Practice Address - Street 1:580 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2705
Practice Address - Country:US
Practice Address - Phone:906-225-4718
Practice Address - Fax:906-225-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1048520001Medicare ID - Type Unspecified