Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 624 W M-60, Union City, Michigan |
Authorized Official Name and Position | Richard Trufant (CFO) |
Authorized Official Contact | 5172795396 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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624 W M-60 Union City MI 49094 Ph: (517) 741-7989 | 624 W M-60 Union City MI 49094 Ph: (517) 741-7989 |
NPI Number | 1093751331 |
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Provider Enumeration Date | 06/22/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9335037514 |
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Medicare Enrollment ID | O20040510001545 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093751331 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 120010 (Michigan) | Primary |