Healthcare Provider Details

I. General information

NPI: 1710386776
Provider Name (Legal Business Name): COUNTY OF INGHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 S PENNSYLVANIA AVE
LANSING MI
48912-1669
US

IV. Provider business mailing address

PO BOX 30161
LANSING MI
48909-7661
US

V. Phone/Fax

Practice location:
  • Phone: 517-702-3500
  • Fax: 517-484-5169
Mailing address:
  • Phone: 517-887-4383
  • Fax: 517-244-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateMI

VIII. Authorized Official

Name: ADENIKE TOLULUPE SHOYINKA
Title or Position: MEDICAL HEALTH OFFICER
Credential: MD
Phone: 517-887-4466