Provider Demographics
NPI:1427277847
Name:HILLS & DALES GENERAL HOSPITAL, INC.
Entity type:Organization
Organization Name:HILLS & DALES GENERAL HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:989-912-6225
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:2254 MAIN ST
Mailing Address - City:UBLY
Mailing Address - State:MI
Mailing Address - Zip Code:48475-0273
Mailing Address - Country:US
Mailing Address - Phone:989-658-9191
Mailing Address - Fax:989-658-2231
Practice Address - Street 1:2254 MAIN ST
Practice Address - Street 2:
Practice Address - City:UBLY
Practice Address - State:MI
Practice Address - Zip Code:48475-0273
Practice Address - Country:US
Practice Address - Phone:989-658-9191
Practice Address - Fax:989-658-2231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLS & DALES GENERAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700C210080OtherBLUE CROSS PIN NUMBER
MI700C210080OtherBLUE CROSS PIN NUMBER