Provider Demographics
NPI:1699377184
Name:PAUL OLIVER MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:PAUL OLIVER MEMORIAL HOSPITAL
Other - Org Name:FRANKFORT MEDICAL GROUP A SERVICE OF PAUL OLIVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO SOUTH REIGON
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-352-2259
Mailing Address - Street 1:224 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:MI
Mailing Address - Zip Code:49635-9658
Mailing Address - Country:US
Mailing Address - Phone:231-835-2088
Mailing Address - Fax:231-825-2534
Practice Address - Street 1:224 PARK AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:MI
Practice Address - Zip Code:49635-9658
Practice Address - Country:US
Practice Address - Phone:231-835-2088
Practice Address - Fax:231-825-2534
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL OLIVER MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty