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609 W Central Ave Rm Tb1 Mackinaw City MI 49701-9650 | |
(231) 597-9585 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 609 W Central Ave Rm Tb1, Mackinaw City, Michigan |
Authorized Official Name and Position | Richard Bates (INTERIM CEO) |
Authorized Official Contact | 9897424583 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 427 Hillman MI 49746-0427 Ph: (989) 742-4583 | 609 W Central Ave Rm Tb1 Mackinaw City MI 49701-9650 Ph: (231) 597-9585 |
NPI Number | 1396382677 |
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Provider Enumeration Date | 12/05/2019 |
Last Update Date | 03/13/2023 |
Identifier | Type | State | Issuer |
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1396382677 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |