Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes | |
8354 100th Ave Ste 1 Canadian Lakes MI 49346-8345 | |
(231) 972-6000 | |
(231) 972-6003 |
Full Name | Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes |
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Speciality | Clinic/Center |
Location | 8354 100th Ave Ste 1, Canadian Lakes, Michigan |
Authorized Official Name and Position | Amanda Knuth (CONTROLLER) |
Authorized Official Contact | 2313491616 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes 100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 Ph: (616) 486-6790 | Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes 8354 100th Ave Ste 1 Canadian Lakes MI 49346-8345 Ph: (231) 972-6000 |
NPI Number | 1477973493 |
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Provider Enumeration Date | 04/17/2014 |
Last Update Date | 08/22/2023 |
Medicare PECOS PAC ID | 1951215540 |
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Medicare Enrollment ID | O20130328000248 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477973493 | NPI | - | NPPES |
23-8667 | Other | CMS CERTIFICATION NUMBER |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |