Healthcare Provider Details
I. General information
NPI: 1083705024
Provider Name (Legal Business Name): MEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1131 E M-46
EDMORE MI
48829-0529
US
IV. Provider business mailing address
PO BOX 529
EDMORE MI
48829-0529
US
V. Phone/Fax
- Phone: 989-427-5070
- Fax: 989-427-3690
- Phone: 989-427-5070
- Fax: 989-427-3690
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRUCE
ROBERT
REAMES
JR.
Title or Position: OWNER/PRESIDENT
Credential: PA C
Phone: 989-427-5070