Provider Demographics
NPI:1659490803
Name:CARSON CITY HOSPITAL
Entity Type:Organization
Organization Name:CARSON CITY HOSPITAL
Other - Org Name:MSG BCBS GROUP PSYCHIATRISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:MSG DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSLEPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-584-3971
Mailing Address - Street 1:406 E ELM ST
Mailing Address - Street 2:PO BOX 730
Mailing Address - City:CARSON CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48811-9693
Mailing Address - Country:US
Mailing Address - Phone:989-584-3971
Mailing Address - Fax:989-584-6734
Practice Address - Street 1:406 E ELM ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-9693
Practice Address - Country:US
Practice Address - Phone:989-584-3971
Practice Address - Fax:989-584-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty