Organization · Type 2 NPI

Bronson Lakeview Hospital

Rural Health Clinic/Center · Bangor, MI

NPI number 1104459627 Active

Practice location

520 Railroad St
Bangor, MI 49013-1490

Call (269) 427-5811 Map

Fax (269) 427-6107

Mailing address

301 John St # 42
Kalamazoo, MI 49007-5295

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

6 other providers at this address

NPI record

NPI: 1104459627
Entity type: Organization (Type 2)
Issued: Feb 13, 2020
Last updated: Nov 27, 2023
Status: Active
Subpart: Yes of Bronson Lakeview Hospital

Other names

<unavail>
Bronson Lakeview Family Care Bangor · doing business as
Bronson Lakeview Family Care Bangor · doing business as

Authorized official

Rebecca East
CFO
(269) 341-6000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104459627

Bronson Lakeview Hospital's National Provider Identifier is 1104459627, issued on Feb 13, 2020. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Bangor, MI. The record was last updated on Nov 27, 2023.