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14540 N Mackinaw Highway Mackinaw City MI 49701-9507 | |
(231) 436-9900 | |
(231) 436-5357 |
Full Name | |
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Speciality | Clinic/Center |
Location | 14540 N Mackinaw Highway, Mackinaw City, Michigan |
Authorized Official Name and Position | Jason C Anderson (CFO) |
Authorized Official Contact | 9066430435 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1140 N State St Saint Ignace MI 49781-1048 Ph: (906) 643-8585 | 14540 N Mackinaw Highway Mackinaw City MI 49701-9507 Ph: (231) 436-9900 |
NPI Number | 1245554914 |
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Provider Enumeration Date | 03/24/2010 |
Last Update Date | 11/12/2024 |
Medicare PECOS PAC ID | 1456420876 |
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Medicare Enrollment ID | O20110406000985 |
Identifier | Type | State | Issuer |
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1245554914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |