| Organization Name: | MEMORIAL MEDICAL CENTER OF WEST MICHIGAN |
| NPI Number: | 1861800674 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RANDALL STASIK (PESIDENT) |
| Mailing Address: | 2481 N 72nd Ave Hart |
| State: | MI US |
| Postal Code: | 494208008 |
| Phone Number: | 2318732163 |
| Fax Number: | 2318732143 |
| NPI Enumeration Date: | 07/24/2014 |
| NPI Last Update Date: | 06/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |