| Gardner Community Health Center | |
|
333 Dahlia Dr Lansing MI 48911-3789 | |
| (517) 244-8019 | |
| (517) 244-7174 |
| Full Name | Gardner Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 Dahlia Dr, Lansing, Michigan |
| Authorized Official Name and Position | Kris Drake (DHO / ED) |
| Authorized Official Contact | 5178874361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gardner Community Health Center Po Box 30161 Lansing MI 48909-7661 Ph: (517) 244-8019 | Gardner Community Health Center 333 Dahlia Dr Lansing MI 48911-3789 Ph: (517) 244-8019 |
| NPI Number | 1679130942 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 04/28/2022 |
| Medicare PECOS PAC ID | 7810899622 |
|---|---|
| Medicare Enrollment ID | O20200302000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679130942 | NPI | - | NPPES |
| 0M77560 | Other | MI | MEDICARE PIN |
| 231155 | Other | MI | PTAN |
| 0C36051 | Other | MI | MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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