| Willow Community Health Center | |
|
1115 S Pennsylvania Ave Lansing MI 48912-1669 | |
| (517) 702-3500 | |
| (517) 484-5169 |
| Full Name | Willow Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1115 S Pennsylvania 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 |
|---|---|
| Willow Community Health Center Po Box 30161 Lansing MI 48909-7661 Ph: (517) 887-4467 | Willow Community Health Center 1115 S Pennsylvania Ave Lansing MI 48912-1669 Ph: (517) 702-3500 |
| NPI Number | 1710386776 |
|---|---|
| Provider Enumeration Date | 08/15/2014 |
| Last Update Date | 04/28/2022 |
| Medicare PECOS PAC ID | 7810899622 |
|---|---|
| Medicare Enrollment ID | O20140905001734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710386776 | NPI | - | NPPES |
| 231041 | Other | MI | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Michigan) | Primary |
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Willow Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 306 W Willow St, Lansing, MI 48906 Phone: 517-702-3500 Fax: 517-484-5169 |