NPIMap

Organization Active NPI

Herrick Memorial Hospital, Inc.

  • Nursing Facility/Intermediate Care Facility
  • Tecumseh, MI
National Provider Identifier
1760552574
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
464010 Issued in MI
Legal business name
HERRICK MEMORIAL HOSPITAL, INC.
Doing business as
Herrick Manor
Practice address
502 East Pottawattamie St.
Tecumseh, MI 49286-2018
Phone
(517) 424-3365
Fax
(517) 424-3902
NPI assigned
Nov 9, 2006
Organization subpart
Yes
Parent organization
HERRICK MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hayley M. Stuber
Title
Director
Phone
(419) 824-7576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 464010 MI Primary

Addresses

Primary practice location

502 East Pottawattamie St.
Tecumseh, MI 49286-2018

Mailing address

502 East Pottawattamie St.
Tecumseh, MI 49286-2018
Phone (517) 424-3365

Other identifiers 1

IdentifierTypeStateIssuer
464010MedicaidMI

Other names 1

  • Herrick Manor Doing business as

National Provider Directory

National Provider Directory
Part of
James Bengston MD

Locations

502 E Pottawattamie St
Tecumseh, MI 49286
Phone (517) 424-3365

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1760552574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EAST POTTAWATTAMIE ST.",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492862018",
            "telephone_number": "517-424-3365",
            "fax_number": "517-424-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EAST POTTAWATTAMIE ST.",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492862018",
            "telephone_number": "517-424-3365",
            "fax_number": "517-424-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERRICK MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERRICK MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "STUBER",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-824-7576"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "464010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herrick Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tecumseh, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.