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601 Calumet St Lake Linden MI 49945-1002 | |
(906) 483-1705 | |
(906) 372-3230 |
Full Name | |
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Speciality | Clinic/Center |
Location | 601 Calumet St, Lake Linden, Michigan |
Authorized Official Name and Position | Donald Simila (CEO) |
Authorized Official Contact | 9064818571 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 Explorer St Gwinn MI 49841-2813 Ph: (906) 483-1705 | 601 Calumet St Lake Linden MI 49945-1002 Ph: (906) 483-1705 |
NPI Number | 1780318345 |
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Provider Enumeration Date | 07/11/2022 |
Last Update Date | 11/11/2024 |
Medicare PECOS PAC ID | 1951432384 |
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Medicare Enrollment ID | O20230224001412 |
Identifier | Type | State | Issuer |
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1780318345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Portage Physician Practices Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 9th St, Lake Linden, MI 49945 Phone: 906-483-1030 Fax: 906-296-0521 | |