Healthcare Provider Details

I. General information

NPI: 1962089888
Provider Name (Legal Business Name): HEALTHBAAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 FULLER AVE NE
GRAND RAPIDS MI
49503-1912
US

IV. Provider business mailing address

2230 CHESAPEAKE DR NE
GRAND RAPIDS MI
49505-6407
US

V. Phone/Fax

Practice location:
  • Phone: 616-200-8435
  • Fax:
Mailing address:
  • Phone: 616-200-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. NATHAN BAAR
Title or Position: CEO
Credential: MHA, BSN, RN, CEN
Phone: 616-200-8584