Provider Demographics
NPI:1447602628
Name:HACKLEY HOSPITAL
Entity Type:Organization
Organization Name:HACKLEY HOSPITAL
Other - Org Name:MERCY HEALTH PARTNERS-WORKPLACE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEESSIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-728-4023
Mailing Address - Street 1:5730 W US HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2452
Mailing Address - Country:US
Mailing Address - Phone:231-316-1019
Mailing Address - Fax:231-316-1088
Practice Address - Street 1:5730 W US HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2452
Practice Address - Country:US
Practice Address - Phone:231-316-1019
Practice Address - Fax:231-316-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine