| Ida Family Wellness Center | |
|
3160 Lewis Ave Ida MI 48140-9703 | |
| (888) 432-3621 | |
| (866) 390-9167 |
| Full Name | Ida Family Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3160 Lewis Ave, Ida, Michigan |
| Authorized Official Name and Position | Layth Maolood (PHYSICIAN) |
| Authorized Official Contact | 7343223379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ida Family Wellness Center 3160 Lewis Ave Ida MI 48140-9703 Ph: (888) 432-3621 | Ida Family Wellness Center 3160 Lewis Ave Ida MI 48140-9703 Ph: (888) 432-3621 |
| NPI Number | 1831113414 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 02/05/2016 |
| Medicare PECOS PAC ID | 5294625364 |
|---|---|
| Medicare Enrollment ID | O20040319001341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831113414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4301068044 (Michigan) | Primary |
| Provider Name | Layth Maolood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790788701 PECOS PAC ID: 5991699753 Enrollment ID: I20040323000846 |
| Provider Name | Amy Altamash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003288457 PECOS PAC ID: 3870893878 Enrollment ID: I20151124000344 |
| Provider Name | Kristi Lorenc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043686710 PECOS PAC ID: 9638488810 Enrollment ID: I20210819001665 |