Provider Demographics
NPI:1801538871
Name:BRONSON LAKEVIEW HOSPITAL
Entity type:Organization
Organization Name:BRONSON LAKEVIEW HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-341-6000
Mailing Address - Street 1:301 JOHN ST # 42
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5295
Mailing Address - Country:US
Mailing Address - Phone:269-341-8536
Mailing Address - Fax:269-341-8913
Practice Address - Street 1:930 BLUE STAR HWY
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-7758
Practice Address - Country:US
Practice Address - Phone:269-637-1115
Practice Address - Fax:269-639-1314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRONSN LAKEVIEW HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health