Provider Demographics
NPI:1720766181
Name:LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Entity Type:Organization
Organization Name:LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-391-2022
Mailing Address - Street 1:100 MICHIGAN NE ST MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-3606
Practice Address - Country:US
Practice Address - Phone:269-408-2258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty