Provider Demographics
NPI:1366866956
Name:BRONSON METHODIST HOSPITAL
Entity Type:Organization
Organization Name:BRONSON METHODIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRINK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:269-341-7909
Mailing Address - Street 1:601 JOHN ST STE M-425
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5354
Mailing Address - Country:US
Mailing Address - Phone:269-341-7909
Mailing Address - Fax:269-341-7648
Practice Address - Street 1:601 JOHN ST STE M-425
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5354
Practice Address - Country:US
Practice Address - Phone:269-341-7909
Practice Address - Fax:269-341-7648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037161282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital