Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 230 S Maple St, Grant, Michigan |
Authorized Official Name and Position | John Sella (CONTROLLER) |
Authorized Official Contact | 6168020206 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 Ph: () - | 230 S Maple St Grant MI 49327-9006 Ph: (231) 834-5995 |
NPI Number | 1932662996 |
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Provider Enumeration Date | 04/08/2019 |
Last Update Date | 08/23/2023 |
Medicare PECOS PAC ID | 3678543659 |
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Medicare Enrollment ID | O20190801000526 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932662996 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Grant Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 S Maple, Grant, MI 49327 Phone: 231-834-5995 Fax: 231-834-0248 | |
Gerald Van Wieren, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 71 S Front St, Grant, MI 49327 Phone: 231-834-5676 Fax: 231-834-7211 |