Healthcare Provider Details

I. General information

NPI: 1568414589
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER CLARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N MCEWAN ST
CLARE MI
48617-1440
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-802-5000
  • Fax:
Mailing address:
  • Phone: 989-802-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number180010
License Number StateMI

VIII. Authorized Official

Name: AMANDA M PEIRCE
Title or Position: MANAGER
Credential:
Phone: 989-356-7597