| Great Lakes Bay Health Centers Bridgeport Spaulding High School | |
|
4691 Bearcat Blvd Bridgeport MI 48722-9581 | |
| (989) 777-0440 | |
| Not Available |
| Full Name | Great Lakes Bay Health Centers Bridgeport Spaulding High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 4691 Bearcat Blvd, Bridgeport, Michigan |
| Authorized Official Name and Position | Dawn Christian (PROVIDER ENROLLMENT) |
| Authorized Official Contact | 9897596464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Bay Health Centers Bridgeport Spaulding High School 501 Lapeer Ave Saginaw MI 48607-1203 Ph: (989) 759-6464 | Great Lakes Bay Health Centers Bridgeport Spaulding High School 4691 Bearcat Blvd Bridgeport MI 48722-9581 Ph: (989) 777-0440 |
| NPI Number | 1073169835 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 08/26/2019 |
| Medicare PECOS PAC ID | 2466369046 |
|---|---|
| Medicare Enrollment ID | O20191105001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073169835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Great Lakes Bay Health Centers Bridgeport Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6297 Dixie Highway, Bridgeport, MI 48722 Phone: 989-759-6460 Fax: 989-759-6465 | |
Cass River Health Plaza Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6940 Dixie Hwy, Bridgeport, MI 48722 Phone: 989-746-0933 Fax: 989-746-5070 | |
Great Lakes Bay Health Center Bridgeport Dental Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6297 Dixie Highway, Bridgeport, MI 48722 Phone: 989-821-5390 Fax: 989-921-5389 |