Healthcare Provider Details

I. General information

NPI: 1922464254
Provider Name (Legal Business Name): NORTHWEST MICHIGAN HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 FRANKFORT HWY
BENZONIA MI
49616-9558
US

IV. Provider business mailing address

10767 E TRAVERSE HWY
TRAVERSE CITY MI
49684-6219
US

V. Phone/Fax

Practice location:
  • Phone: 231-947-1112
  • Fax: 231-947-7739
Mailing address:
  • Phone: 231-947-0351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. HEIDI MAE BRITTON
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: MPH,
Phone: 231-947-1112