MEDICARE: HAMILTON COMMUNITY HEALTH NETWORK INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)		MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	23-1907	OTHER	MI	MEDICARE PART A: 420 W. FIFTH AVE., FLINT, MI 48503
5	23-1880	OTHER	MI	MEDICARE PART A: 5710 CLIO RD., FLINT, MI 48504
6	23-1886	OTHER	MI	MEDICARE PART A: G-3375 S. SAGINAW ST., BURTON, MI 48529
7	23-1806	OTHER	MI	MEDICARE PART A: 4001 N. SAGINAW ST., FLINT, MI 48505

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386624278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON COMMUNITY HEALTH NETWORK INC.

Provider Business Mailing Address
First Line	:	225 E 5TH ST
Second Line	:	SUITE 300
City	:	FLINT
State	:	MI
Zip	:	48502-1641
Country	:	US
Telephone Number	:	810-406-4246
Fax Number	:	810-424-6029

Provider Business Practice Location Address
First Line	:	225 E 5TH ST
Second Line	:	SUITE 300
City	:	FLINT
State	:	MI
Zip	:	48502-1641
Country	:	US
Telephone Number	:	810-406-4246
Fax Number	:	810-424-6029

Authorized Official
Title or Position	:	CEO
Name	:	CLARENCE R. PIERCE
Credential	:
Telephone Number	:	810-406-4950

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/21/2022

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