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815 N Fairview Ave Lansing MI 48912-3129 | |
(517) 244-8019 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 815 N Fairview Ave, 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 | 815 N Fairview Ave Lansing MI 48912-3129 Ph: (517) 244-8019 |
NPI Number | 1558928747 |
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Provider Enumeration Date | 05/22/2019 |
Last Update Date | 04/28/2022 |
Medicare PECOS PAC ID | 7810899622 |
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Medicare Enrollment ID | O20200317000185 |
Identifier | Type | State | Issuer |
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1558928747 | NPI | - | NPPES |
231158 | Other | MI | PTAN |
Taxonomy | Type | License (State) | Status |
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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 | |