Provider Demographics
NPI:1598982837
Name:ASCENSION GENESYS HOSPITAL
Entity Type:Organization
Organization Name:ASCENSION GENESYS HOSPITAL
Other - Org Name:WEST FLINT HEALTH CENTER SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-606-5893
Mailing Address - Street 1:5445 ALI DR DEPT 300
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5193
Mailing Address - Country:US
Mailing Address - Phone:810-695-9981
Mailing Address - Fax:
Practice Address - Street 1:420 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1803
Practice Address - Country:US
Practice Address - Phone:810-232-3522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty