Provider Demographics
NPI:1972534360
Name:HILLSDALE COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:HILLSDALE COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-437-4451
Mailing Address - Street 1:49 E CARLETON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1619
Mailing Address - Country:US
Mailing Address - Phone:517-437-8371
Mailing Address - Fax:
Practice Address - Street 1:451 HIDDEN MEADOWS DR
Practice Address - Street 2:SUITE 250
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242
Practice Address - Country:US
Practice Address - Phone:517-437-8371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5440220001Medicare NSC
5440220001Medicare ID - Type Unspecified