| |
440 Garfield Ave Cheboygan MI 49721-2011 | |
(231) 627-5211 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 440 Garfield Ave, Cheboygan, Michigan |
Authorized Official Name and Position | Richard Bates (CEO) |
Authorized Official Contact | 9897424583 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 427 Hillman MI 49746-0427 Ph: (989) 354-2197 | 440 Garfield Ave Cheboygan MI 49721-2011 Ph: (231) 627-5211 |
NPI Number | 1598148157 |
---|---|
Provider Enumeration Date | 07/01/2015 |
Last Update Date | 03/13/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598148157 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Leja Jackson Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 S Huron St, Cheboygan, MI 49721 Phone: 231-597-8192 Fax: 231-597-8463 | |