Provider Demographics
NPI:1295803377
Name:ASCENSION BORGESS ALLEGAN HOSPITAL
Entity type:Organization
Organization Name:ASCENSION BORGESS ALLEGAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-226-4800
Mailing Address - Street 1:1717 SHAFER STREET, SUITE 002
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:269-552-2964
Practice Address - Street 1:555 LINN ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1524
Practice Address - Country:US
Practice Address - Phone:269-686-4051
Practice Address - Fax:269-686-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI030032282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ024464Medicaid
FL091971300Medicaid
ID807082900Medicaid
MI405170030Medicaid
MI00117OtherBLUE CROSS
KY01411552Medicaid
MI231328OtherHUMANA
MI301558020Medicaid
MN638850700Medicaid
OH0273314Medicaid
IN100033860AMedicaid
SC11521BMedicaid
ALALL0042NMedicaid
AR113396105Medicaid