Provider Demographics
NPI:1972564730
Name:EMMA L. BIXBY MEDICAL CENTER
Entity Type:Organization
Organization Name:EMMA L. BIXBY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REV CYCLE
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-585-7576
Mailing Address - Street 1:818 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1446
Mailing Address - Country:US
Mailing Address - Phone:517-265-0900
Mailing Address - Fax:517-265-0496
Practice Address - Street 1:5640 N ADRIAN HWY
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8318
Practice Address - Country:US
Practice Address - Phone:517-577-0000
Practice Address - Fax:517-265-0496
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-31
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1945516Medicaid
MI00190OtherBCBS
MIH44002OtherMCARE
MI104682OtherPREFERRED CHOICES/CARE CH
MI05035OtherPARAMOUNT
MI1945534Medicaid
MI1945534Medicaid