| Elder Care Of West Michigan Pllc | |
|
6785 Myers Lake Ave Ne Rockford MI 49341-7416 | |
| (616) 366-4234 | |
| (616) 469-1118 |
| Full Name | Elder Care Of West Michigan Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 6785 Myers Lake Ave Ne, Rockford, Michigan |
| Authorized Official Name and Position | Kathy Jo Uecker (BUSINESS MANAGER) |
| Authorized Official Contact | 2694209404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elder Care Of West Michigan Pllc 4448 Koinonia Dr Ne Grand Rapids MI 49525-9332 Ph: () - | Elder Care Of West Michigan Pllc 6785 Myers Lake Ave Ne Rockford MI 49341-7416 Ph: (616) 366-4234 |
| NPI Number | 1427514306 |
|---|---|
| Provider Enumeration Date | 02/15/2019 |
| Last Update Date | 05/02/2019 |
| Medicare PECOS PAC ID | 9830431311 |
|---|---|
| Medicare Enrollment ID | O20190502001592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427514306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Secondary |
| Provider Name | Jeffrey Robert Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881641165 PECOS PAC ID: 5294789053 Enrollment ID: I20050304000538 |
| Provider Name | Gretchen C Schumacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235152935 PECOS PAC ID: 3274631452 Enrollment ID: I20100422000417 |
| Provider Name | Angela Kuklewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578941571 PECOS PAC ID: 5698088334 Enrollment ID: I20150723008369 |
| Provider Name | Hilary J Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710469366 PECOS PAC ID: 4486075520 Enrollment ID: I20200528001394 |
| Provider Name | Mohamed A. Mohamed |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972180131 PECOS PAC ID: 0143666966 Enrollment ID: I20240314001873 |
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