Provider Demographics
NPI:1447586094
Name:NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Other - Org Name:NEW YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STASIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-924-1340
Mailing Address - Street 1:1401 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-1486
Mailing Address - Country:US
Mailing Address - Phone:231-924-3300
Mailing Address - Fax:231-924-1164
Practice Address - Street 1:1401 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1486
Practice Address - Country:US
Practice Address - Phone:231-924-3300
Practice Address - Fax:231-924-1164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERBER MEMORIAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-02
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty