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430 N Larch St Ste 1 Lansing MI 48912-1283 | |
(517) 253-5000 | |
(517) 253-5010 |
Full Name | |
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Speciality | Clinic/Center |
Location | 430 N Larch St Ste 1, Lansing, Michigan |
Authorized Official Name and Position | Kris Drake (DHO/ ED) |
Authorized Official Contact | 5178874361 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 30161 Lansing MI 48909-7661 Ph: (517) 244-8019 | 430 N Larch St Ste 1 Lansing MI 48912-1283 Ph: (517) 253-5000 |
NPI Number | 1326560145 |
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Provider Enumeration Date | 07/13/2017 |
Last Update Date | 04/28/2022 |
Medicare PECOS PAC ID | 7810899622 |
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Medicare Enrollment ID | O20171017003189 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326560145 | NPI | - | NPPES |
1326560145 | Medicaid | MI | |
0C36051 | Other | MI | MEDICARE PIN |
0M77560 | Other | MI | MEDICARE PIN |
231118 | Other | MI | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mi Post Acute Specialists Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 707 Armstrong Rd, Lansing, MI 48911 Phone: 800-411-6768 | |
Lansing Family Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4202 Collins Rd, Suite 115, Lansing, MI 48910 Phone: 517-484-4520 Fax: 517-484-3930 | |
Ingham County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5303 S Cedar St, Lansing, MI 48911 Phone: 517-887-4311 | |