Provider Demographics
NPI:1902981889
Name:MARLETTE REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:MARLETTE REGIONAL HOSPITAL
Other - Org Name:UNITED HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:BABCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-635-4002
Mailing Address - Street 1:2770 MAIN ST
Mailing Address - Street 2:PO BOX 307
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1141
Mailing Address - Country:US
Mailing Address - Phone:989-635-4000
Mailing Address - Fax:989-635-4056
Practice Address - Street 1:2770 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-1141
Practice Address - Country:US
Practice Address - Phone:989-635-4000
Practice Address - Fax:989-635-4056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI151791895Medicaid
MA0980897OtherHEALTHPLUS
MI138037OtherGREAT LAKES HEALTH PLAN
MI08705OtherBLUE CROSS
MI151791895Medicaid