Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 230 W Oak St, Fremont, Michigan |
Authorized Official Name and Position | John Sella (CONTROLLER) |
Authorized Official Contact | 6168020206 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 Ph: (616) 486-6790 | 230 W Oak St Fremont MI 49412-1526 Ph: (231) 924-4200 |
NPI Number | 1194118265 |
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Provider Enumeration Date | 03/12/2015 |
Last Update Date | 08/22/2023 |
Medicare PECOS PAC ID | 4880503051 |
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Medicare Enrollment ID | O20150512002458 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194118265 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mobile Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 E Main St, Fremont, MI 49412 Phone: 231-924-0244 Fax: 231-924-4882 | |
Pine Medical Group Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 W Oak St, Fremont, MI 49412 Phone: 231-924-4200 Fax: 231-924-2027 | |
Spectrum Health Hospitals Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 W Oak St, Fremont, MI 49412 Phone: 616-267-9823 | |
Pine Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 W Oak St, Fremont, MI 49412 Phone: 231-924-4200 Fax: 231-924-2027 |