Provider Demographics
NPI:1750465480
Name:LAUREL HEALTH CARE COMPANY OF BATTLE CREEK
Entity Type:Organization
Organization Name:LAUREL HEALTH CARE COMPANY OF BATTLE CREEK
Other - Org Name:THE LAURELS OF BEDFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-794-8800
Mailing Address - Street 1:270 BEDFORD RD N
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-1835
Mailing Address - Country:US
Mailing Address - Phone:616-968-2296
Mailing Address - Fax:616-968-8943
Practice Address - Street 1:270 BEDFORD RD N
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-1835
Practice Address - Country:US
Practice Address - Phone:616-968-2296
Practice Address - Fax:616-968-8943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI134150332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI134150OtherNH LICENSE #
MI3198257Medicaid
MI09668OtherBC/BS #
MI7105579OtherUNITED HEALTH CARE ID#
MI3198257Medicaid