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945 Ninth Street Lake Linden MI 49945-1100 | |
(906) 483-1030 | |
(906) 372-3230 |
Full Name | |
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Speciality | Clinic/Center |
Location | 945 Ninth Street, Lake Linden, Michigan |
Authorized Official Name and Position | Donald A Simila (CEO) |
Authorized Official Contact | 9064831325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 Explorer St Gwinn MI 49841-2813 Ph: (906) 483-1030 | 945 Ninth Street Lake Linden MI 49945-1100 Ph: (906) 483-1030 |
NPI Number | 1740603885 |
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Provider Enumeration Date | 01/25/2014 |
Last Update Date | 11/11/2024 |
Medicare PECOS PAC ID | 1951432384 |
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Medicare Enrollment ID | O20140324001404 |
Identifier | Type | State | Issuer |
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1740603885 | NPI | - | NPPES |
Portage Physician Practices Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 9th St, Lake Linden, MI 49945 Phone: 906-483-1030 Fax: 906-296-0521 | |