Provider Demographics
NPI:1457368615
Name:AURORA MEDICAL CENTER BAY AREA, INC.
Entity Type:Organization
Organization Name:AURORA MEDICAL CENTER BAY AREA, INC.
Other - Org Name:AMCBA-STEPHENSON
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-299-1610
Mailing Address - Street 1:S 927 US HWY 41
Mailing Address - Street 2:
Mailing Address - City:STEPHENSON
Mailing Address - State:MI
Mailing Address - Zip Code:49887
Mailing Address - Country:US
Mailing Address - Phone:906-753-4703
Mailing Address - Fax:906-753-4802
Practice Address - Street 1:S 927 US HWY 41
Practice Address - Street 2:
Practice Address - City:STEPHENSON
Practice Address - State:MI
Practice Address - Zip Code:49887
Practice Address - Country:US
Practice Address - Phone:906-753-4703
Practice Address - Fax:906-753-4802
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AURORA MEDICAL CENTER BAY AREA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-01
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0526520003Medicare NSC