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1110 10th Ave Menominee MI 49858-3058 | |
(906) 290-5000 | |
(906) 863-2408 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1110 10th Ave, Menominee, Michigan |
Authorized Official Name and Position | Donald A Simila (CEO) |
Authorized Official Contact | 9064831325 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 Explorer St Gwinn MI 49841-2813 Ph: (906) 290-5000 | 1110 10th Ave Menominee MI 49858-3058 Ph: (906) 290-5000 |
NPI Number | 1801214218 |
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Provider Enumeration Date | 04/02/2014 |
Last Update Date | 11/11/2024 |
Medicare PECOS PAC ID | 1951432384 |
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Medicare Enrollment ID | O20150516000047 |
Identifier | Type | State | Issuer |
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1801214218 | NPI | - | NPPES |
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