| Ottawa Hills High School Health Center | |
|
2055 Rosewood Ave Se Grand Rapids MI 49506-5248 | |
| (616) 776-5110 | |
| (616) 776-5111 |
| Full Name | Ottawa Hills High School Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2055 Rosewood Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Tasha Blackmon (CEO) |
| Authorized Official Contact | 6169658215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ottawa Hills High School Health Center 100 Cherry St Se Grand Rapids MI 49503-4526 Ph: (616) 965-8200 | Ottawa Hills High School Health Center 2055 Rosewood Ave Se Grand Rapids MI 49506-5248 Ph: (616) 776-5110 |
| NPI Number | 1124187471 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 6800707647 |
|---|---|
| Medicare Enrollment ID | O20131205001914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124187471 | NPI | - | NPPES |
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