Healthcare Provider Details

I. General information

NPI: 1497640213
Provider Name (Legal Business Name): BALDWIN FAMILY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15044 220TH AVE
BIG RAPIDS MI
49307-9248
US

IV. Provider business mailing address

PO BOX 706
WHITE CLOUD MI
49349-0706
US

V. Phone/Fax

Practice location:
  • Phone: 231-527-7160
  • Fax: 231-622-4157
Mailing address:
  • Phone: 231-689-7156
  • Fax: 231-689-3869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE TATKO
Title or Position: PRESIDENT & CEO
Credential:
Phone: 231-745-5482