Healthcare Provider Details

I. General information

NPI: 1508868662
Provider Name (Legal Business Name): ISABELLA COUNTY MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 NORTH DR
MT PLEASANT MI
48858-3200
US

IV. Provider business mailing address

1222 NORTH DR
MT PLEASANT MI
48858-3200
US

V. Phone/Fax

Practice location:
  • Phone: 989-772-2957
  • Fax: 989-772-3669
Mailing address:
  • Phone: 989-772-2957
  • Fax: 989-772-3669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number378510
License Number StateMI

VIII. Authorized Official

Name: NETANIS BAUMANN
Title or Position: ADMINISTRATOR
Credential:
Phone: 989-772-2957