Healthcare Provider Details

I. General information

NPI: 1235214362
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF WEST AND NORTHERN MI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 FULTON ST E SUITE 226
GRAND RAPIDS MI
49503-3200
US

IV. Provider business mailing address

233 FULTON ST E SUITE 226
GRAND RAPIDS MI
49503-3200
US

V. Phone/Fax

Practice location:
  • Phone: 616-451-4988
  • Fax: 616-451-0120
Mailing address:
  • Phone: 616-451-4988
  • Fax: 616-451-0120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: SUZY REITER
Title or Position: VP OF MEDICAL SERVICES
Credential: RNC, NP
Phone: 616-774-7005