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4955 S M 88 Hwy Bellaire MI 49615-9082 | |
(231) 533-8649 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 4955 S M 88 Hwy, Bellaire, Michigan |
Authorized Official Name and Position | Diane Hawley (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 2315362206 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4955 S M 88 Hwy Bellaire MI 49615-9082 Ph: (231) 533-8649 | 4955 S M 88 Hwy Bellaire MI 49615-9082 Ph: (231) 533-8649 |
NPI Number | 1376750091 |
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Provider Enumeration Date | 05/16/2007 |
Last Update Date | 05/23/2024 |
Medicare PECOS PAC ID | 8325932510 |
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Medicare Enrollment ID | O20060907000200 |
Identifier | Type | State | Issuer |
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1376750091 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |