| Hart Family Medical Center | |
|
611 E Main St Hart MI 49420-1190 | |
| (231) 873-5675 | |
| (231) 873-1825 |
| Full Name | Hart Family Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 611 E Main St, Hart, Michigan |
| Authorized Official Name and Position | Betty Eller (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2316722120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hart Family Medical Center 611 E Main St Hart MI 49420-1190 Ph: (231) 873-5675 | Hart Family Medical Center 611 E Main St Hart MI 49420-1190 Ph: (231) 873-5675 |
| NPI Number | 1972734200 |
|---|---|
| Provider Enumeration Date | 08/04/2009 |
| Last Update Date | 02/24/2020 |
| Certification Date | 02/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972734200 | NPI | - | NPPES |
| 112963232 | Medicaid | MI | |
| CH3289 | Other | MI | RAIL ROAD MEDICARE PTAN |
| 113015197 | Medicaid | MI | |
| 0F40011 | Other | MI | BCBSMI |
| 112963241 | Medicaid | MI | |
| 0F40012 | Other | MI | BCBSM |
| 113269528 | Medicaid | MI | |
| 16106 | Other | MI | BCBS FACILITY CODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | AB033570 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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Hart Family Medical Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 E Main St, Hart, MI 49420 Phone: 231-873-5675 Fax: 231-873-1825 | |
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