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24 E Spring St Port Austin MI 48467-6736 | |
(989) 738-5222 | |
(989) 738-5224 |
Full Name | |
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Speciality | Clinic/Center |
Location | 24 E Spring St, Port Austin, Michigan |
Authorized Official Name and Position | Kenneth Baranski (VP/CFO) |
Authorized Official Contact | 9892691510 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1100 S Van Dyke Rd Bad Axe MI 48413-9615 Ph: (989) 269-9521 | 24 E Spring St Port Austin MI 48467-6736 Ph: (989) 738-5222 |
NPI Number | 1558616086 |
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Provider Enumeration Date | 07/20/2012 |
Last Update Date | 11/14/2024 |
Medicare PECOS PAC ID | 6800709221 |
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Medicare Enrollment ID | O20200803002466 |
Identifier | Type | State | Issuer |
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1558616086 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |