Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 558 Lockwood Ln, Mio, Michigan |
Authorized Official Name and Position | Tara Soules (VP/CFO) |
Authorized Official Contact | 9897726818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1221 South Dr Mt Pleasant MI 48858-3257 Ph: (989) 772-6700 | 558 Lockwood Ln Mio MI 48647-9387 Ph: (989) 826-3271 |
NPI Number | 1215550645 |
---|---|
Provider Enumeration Date | 05/20/2020 |
Last Update Date | 10/25/2021 |
Medicare PECOS PAC ID | 6103733092 |
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Medicare Enrollment ID | O20201215001828 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215550645 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mclaren Bay Region Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 558 Lockwood Ln, Mio, MI 48647 Phone: 989-826-3271 Fax: 989-826-6749 | |
Thunder Bay Community Health Service, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1110 8th Street, Mio, MI 48647 Phone: 989-826-2400 | |
Mclaren Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 558 Lockwood Ln, Mio, MI 48647 Phone: 989-826-3271 Fax: 989-826-6749 |