Provider Demographics
NPI:1194713461
Name:ASCENSION ST JOSEPH HOSPITAL
Entity type:Organization
Organization Name:ASCENSION ST JOSEPH HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIRCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-356-7597
Mailing Address - Street 1:PO BOX 659
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0659
Mailing Address - Country:US
Mailing Address - Phone:989-362-3411
Mailing Address - Fax:989-362-9420
Practice Address - Street 1:200 HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9237
Practice Address - Country:US
Practice Address - Phone:989-362-3411
Practice Address - Fax:989-362-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI350010282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00209OtherBCBS
MI230100Medicare Oscar/Certification