Provider Demographics
NPI:1215970678
Name:HACKLEY HOSPITAL FISCAL SERVICES
Entity type:Organization
Organization Name:HACKLEY HOSPITAL FISCAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR PHYS NETWORK FINAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-727-4455
Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1177
Mailing Address - Country:US
Mailing Address - Phone:231-727-4444
Mailing Address - Fax:231-727-4451
Practice Address - Street 1:6401 PRAIRIE ST
Practice Address - Street 2:STE 2300
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-7840
Practice Address - Country:US
Practice Address - Phone:231-728-4851
Practice Address - Fax:231-758-5694
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F16394Medicare PIN