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56720 Calumet Ave Calumet MI 49913-1967 | |
(906) 483-1177 | |
(906) 372-3230 |
Full Name | |
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Speciality | Clinic/Center |
Location | 56720 Calumet Ave, Calumet, Michigan |
Authorized Official Name and Position | Donald A Simila (CEO) |
Authorized Official Contact | 9064831325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 Explorer St Gwinn MI 49841-2813 Ph: (906) 483-1177 | 56720 Calumet Ave Calumet MI 49913-1967 Ph: (906) 483-1177 |
NPI Number | 1114354479 |
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Provider Enumeration Date | 10/02/2013 |
Last Update Date | 11/11/2024 |
Medicare PECOS PAC ID | 1951432384 |
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Medicare Enrollment ID | O20140218001801 |
Identifier | Type | State | Issuer |
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1114354479 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Michigan) | Primary |
Keweenaw Holistic Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56611 Calumet Ave, Calumet, MI 49913 Phone: 906-337-1844 | |