Full Name | |
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Speciality | General Practice |
Location | 3040 Bourn St, Lewiston, Michigan |
Authorized Official Name and Position | Thomas R. Lemon (CEO) |
Authorized Official Contact | 9897312230 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
829 N Center Ave Gaylord MI 49735-1595 Ph: (989) 731-7777 | 3040 Bourn St Lewiston MI 49756 Ph: (989) 786-4877 |
NPI Number | 1538328364 |
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Provider Enumeration Date | 06/06/2008 |
Last Update Date | 08/22/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538328364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 690020 (Michigan) | Primary |
Rite Aid Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2855 S County Road 489, Lewiston, MI 49756 Phone: 989-786-2239 |