Port Hope Medical Clinic | |
4255 N Lakeshore Rd Port Hope MI 48468 | |
(989) 428-1000 | |
(989) 428-1001 |
Full Name | Port Hope Medical Clinic |
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Speciality | Clinic/Center |
Location | 4255 N Lakeshore Rd, Port Hope, Michigan |
Authorized Official Name and Position | Jill Frances Wehner (VP/COO) |
Authorized Official Contact | 9894795013 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Port Hope Medical Clinic 210 S 1st St Harbor Beach MI 48441-1236 Ph: (989) 479-3201 | Port Hope Medical Clinic 4255 N Lakeshore Rd Port Hope MI 48468 Ph: (989) 428-1000 |
NPI Number | 1164908703 |
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Provider Enumeration Date | 07/17/2018 |
Last Update Date | 07/30/2018 |
Medicare PECOS PAC ID | 7214903483 |
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Medicare Enrollment ID | O20180808001766 |
Identifier | Type | State | Issuer |
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1164908703 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | 4704266641 (Michigan) | Secondary |