| Port Sanilac Healthcare | |
|
245 S Ridge St Port Sanilac MI 48469-9704 | |
| (810) 376-2835 | |
| Not Available |
| Full Name | Port Sanilac Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 245 S Ridge St, Port Sanilac, Michigan |
| Authorized Official Name and Position | Angela Mcconnachie (CEO) |
| Authorized Official Contact | 9896354000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Sanilac Healthcare 245 S Ridge St Port Sanilac MI 48469-9704 Ph: (810) 376-2835 | Port Sanilac Healthcare 245 S Ridge St Port Sanilac MI 48469-9704 Ph: (810) 376-2835 |
| NPI Number | 1306999024 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 3971408121 |
|---|---|
| Medicare Enrollment ID | O20040709000755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306999024 | NPI | - | NPPES |
| 4266244 | Medicaid | MI | |
| 080G910100 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | MO009325 (Michigan) | Primary |
Port Sanilac Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 245 S Ridge St, Port Sanilac, MI 48469 Phone: 810-376-2835 |