Ascension Borgess Allegan Hospital
Organization Active NPI Rural Health Clinic/Center · Fennville, MI
NPI 1861979502 · NPPES record last updated May 31, 2023
Key facts
- NPI
- 1861979502
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ASCENSION BORGESS ALLEGAN HOSPITAL
- Practice address
- 200 N Maple St
Fennville, MI 49408-8478 - Phone
- (269) 561-8761
- Fax
- (269) 686-5438
- NPI assigned
- Jul 25, 2018
- Organization subpart
- No
Authorized official
- Name
- Marina Houghton
- Title
- Cfo
- Phone
- (269) 226-4800
Other NPIs on the same Medicare enrollment 5
Member of 1
Practitioners 6
-
Kenneth Forsman, MD
-
Amanda Doris Mitchell, PA-C, M.S., RD
-
Brenda L Schloff, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100823000998 | MI | Part B Supplier - Clinic/Group Practice | 5092750356 |
Receives reassigned benefits from 50 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Otsego, MI; Gobles, MI; Fennville, MI; Allegan, MI |
National Provider Directory
Locations
200 N Maple St
Fennville, MI 49408
Phone (269) 561-2904
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
200 N Maple St
Fennville, MI 49408-8478
Mailing address
1717 Shaffer Street, Suite 002
Kalamazoo, MI 49048
Other names
- Fennville Medical Center
Other providers in Fennville, MI
- Daniel Mark Alexander
- Shellie R Alexander
- Phillip Louis Badra
- Kanani Baker
- Gloria Jean Braswell
- Courtney Renee Broderick
- Nicole Bustillos
All providers in Fennville, MI · Rural Health Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.