WA FOOTE MEMORIAL HOSPITAL, INC. (NPI# 1306174982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306174982 |
| Entity Type | Organization |
| Organization Name | WA FOOTE MEMORIAL HOSPITAL, INC. |
| Other Organization Name | ALLEGIANCE HOME MEDICAL |
| Practice Address |
1201 E Michigan Ave Suite 110 Jackson MI 49201-1852 |
| Mailing Address |
700 E Michigan Ave Jackson MI 49201-1626 |
| Practice Telephone | 5178177638 |
| Practice Fax Number | 5178177636 |
| Mailing Telephone | 5177688873 |
| Mailing Fax Number | 5177803816 |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2011-04-05 |
| Authorized Official Name | JEANNE' WICKENS (SR. VICE PRESIDENT, FINANCE CFO) |
| Authorized Official Telephone | 5177886979 |
| Is Organization Subpart | Y |
| Parent Organization Name | WA FOOTE MEMORIAL HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 380010 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS OF MICHIGAN | 540C801090 | 01 |
| Other Name | Type Code |
|---|---|
| Allegiance Home Medical | Doing Business As Name - Organization |
| Street Address |
1201 E MICHIGAN AVE SUITE 110 |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-1852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033101225 | Tudor R Tien | Specialist | 1201 E Michigan Ave, Suite 300, Jackson, MI 49201-1852 | 2005-08-16 |
| 1205325180 | Amy M Miskowski | Physical Therapist | 1201 E Michigan Ave, Jackson, MI 49201-1852 | 2018-05-06 |
| 1073002366 | Brett Walter Nowery | Occupational Therapist | 1201 E Michigan Ave, Jackson, MI 49201-1852 | 2018-05-02 |
| 1437651478 | Samantha Sherwood | Nurse Practitioner | 1201 E Michigan Ave, Jackson, MI 49201-1852 | 2018-03-06 |
| 1003314519 | Suzanne Kathleen Harmon | Specialist/Technologist | 1201 E Michigan Ave, Jackson, MI 49201-1852 | 2018-01-30 |
| 1598117319 | Lindsay Michelle Fausett | Specialist/Technologist | 1201 E Michigan Ave, Ste 300, Jackson, MI 49201-1852 | 2016-07-05 |
| 1780051839 | Staci Sue Cattaneo | Nurse Practitioner | 1201 E Michigan Ave, Ste 100, Jackson, MI 49201-1852 | 2015-08-25 |
| 1811254956 | Nanette Embury | Nurse Practitioner | 1201 E Michigan Ave, Ste 120, Jackson, MI 49201-1852 | 2012-04-13 |
| 1043543747 | Amy Lynne Herrick | Nurse Practitioner | 1201 E Michigan Ave, Ste 300, Jackson, MI 49201-1852 | 2009-09-12 |
| 1275627366 | John Joseph Wald | Psychiatry & Neurology | 1201 E Michigan Ave, Ste 230, Jackson, MI 49201-1852 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
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| 1700432754 | Encore Care Inc | Durable Medical Equipment & Medical Supplies | 55 N County Line Rd Ste 6, Jackson, NJ 08527-1394 | 2019-08-15 |
| 1720542855 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 1200 N State St Ste 110, Jackson, MS 39202-2027 | 2019-01-23 |
| 1689142317 | 3 B Labs | Durable Medical Equipment & Medical Supplies | 3011 Greystone Sq, Jackson, TN 38305-3590 | 2018-11-12 |
| 1043726896 | Elite Medical Supply | Durable Medical Equipment & Medical Supplies | 1166 Greenway Dr Ste A3, Jackson, MO 63755-2919 | 2017-12-15 |
| 1124551205 | Quincy Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 5303 Old Cape Rd E Ste A, Jackson, MO 63755-3850 | 2017-04-06 |
| 1295277952 | G & N Enterprise, LLC | Durable Medical Equipment & Medical Supplies | 460 Briarwood Dr Ste 100, Jackson, MS 39206-3053 | 2016-11-12 |
| 1417305665 | J.u.s.t. Orthotics | Durable Medical Equipment & Medical Supplies | 1020 Aspen Dr, Jackson, MO 63755-1152 | 2016-05-27 |
| 1710332325 | Apex Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 189 N Lacey St, Suite 2, Jackson, MO 63755-2496 | 2016-05-02 |
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1285099192 | At-home Medical Supply | Durable Medical Equipment & Medical Supplies | 5015 I 55 N Ste B, Jackson, MS 39206-4306 | 2015-12-18 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.