Healthcare Provider Details

I. General information

NPI: 1417955477
Provider Name (Legal Business Name): OCEANA COUNTY MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E MAIN ST
HART MI
49420-1168
US

IV. Provider business mailing address

701 E MAIN ST
HART MI
49420-1168
US

V. Phone/Fax

Practice location:
  • Phone: 231-873-6600
  • Fax: 231-873-6030
Mailing address:
  • Phone: 231-873-6600
  • Fax: 231-873-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number648510
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number648510
License Number StateMI

VIII. Authorized Official

Name: MR. LARRY K VANSICKLE
Title or Position: CHAIRMAN OF BOARD
Credential:
Phone: 231-873-4052