Provider Demographics
NPI:1952570236
Name:VISITING NURSE & HOSPICE SERVICES OF SOUTHWEST MICHIGAN
Entity Type:Organization
Organization Name:VISITING NURSE & HOSPICE SERVICES OF SOUTHWEST MICHIGAN
Other - Org Name:BORGESS VISITING NURSE & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-343-1396
Mailing Address - Street 1:348 N BURDICK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3830
Mailing Address - Country:US
Mailing Address - Phone:269-343-1396
Mailing Address - Fax:269-382-8006
Practice Address - Street 1:348 N BURDICK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3830
Practice Address - Country:US
Practice Address - Phone:269-343-1396
Practice Address - Fax:269-382-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C91177OtherBCBS MI
MI0C91177OtherBCBS MI