Provider Demographics
NPI:1588199434
Name:LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Entity Type:Organization
Organization Name:LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Other - Org Name:LAKELAND CARDIOLOGY, NILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-983-8300
Mailing Address - Street 1:61 N SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2207
Mailing Address - Country:US
Mailing Address - Phone:269-684-6777
Mailing Address - Fax:269-683-5384
Practice Address - Street 1:61 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2207
Practice Address - Country:US
Practice Address - Phone:269-684-6777
Practice Address - Fax:269-683-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009955282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital