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12851 W M 179 Hwy Wayland MI 49348-9318 | |
| (877) 377-7322 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 12851 W M 179 Hwy, Wayland, 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 Mc 845 Grand Rapids MI 49503-2560 Ph: () - | 12851 W M 179 Hwy Wayland MI 49348-9318 Ph: (877) 377-7322 |
| NPI Number | 1801250907 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 08/23/2023 |
| Medicare PECOS PAC ID | 4587551015 |
|---|---|
| Medicare Enrollment ID | O20180920002843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801250907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Pennock Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12851 W M 179 Hwy, Wayland, MI 49348 Phone: 877-377-7322 | |
Family Physicians, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Parker Dr, Wayland, MI 49348 Phone: 616-406-7799 |