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601 E Chicago Rd White Pigeon MI 49099-9731 | |
(269) 483-7624 | |
(269) 483-7905 |
Full Name | |
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Speciality | Clinic/Center |
Location | 601 E Chicago Rd, White Pigeon, Michigan |
Authorized Official Name and Position | Jeffery Costello (CFO) |
Authorized Official Contact | 5746473460 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3245 Health Dr Ste 100 Ste 100 Granger IN 46530-1380 Ph: () - | 601 E Chicago Rd White Pigeon MI 49099-9731 Ph: (269) 483-7624 |
NPI Number | 1720350903 |
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Provider Enumeration Date | 02/02/2012 |
Last Update Date | 09/18/2023 |
Medicare PECOS PAC ID | 8729245584 |
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Medicare Enrollment ID | O20120216000326 |
Identifier | Type | State | Issuer |
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1720350903 | NPI | - | NPPES |
1720350903 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |