Provider Demographics
NPI:1023052420
Name:GARDEN CITY HOSPITAL
Entity type:Organization
Organization Name:GARDEN CITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JODWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-458-4642
Mailing Address - Street 1:6245 INKSTER RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-4001
Mailing Address - Country:US
Mailing Address - Phone:734-458-1200
Mailing Address - Fax:
Practice Address - Street 1:6245 INKSTER RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-4001
Practice Address - Country:US
Practice Address - Phone:734-458-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARDEN CITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI430Q262800OtherBCBS
MI7222220OtherAETNA
MIOP821374OtherMCARE
MI368375801OtherUSDOL
MI7222220OtherAETNA
MICJ4233Medicare ID - Type UnspecifiedRAILROAD MEDICARE