Healthcare Provider Details

I. General information

NPI: 1205805181
Provider Name (Legal Business Name): DISTRICT HEALTH DEPARTMENT NO. 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 PROGRESS ST
WEST BRANCH MI
48661-8603
US

IV. Provider business mailing address

630 PROGRESS ST
WEST BRANCH MI
48661-8603
US

V. Phone/Fax

Practice location:
  • Phone: 989-345-5020
  • Fax: 989-343-1899
Mailing address:
  • Phone: 989-345-5020
  • Fax: 989-343-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0000009
License Number StateMI

VIII. Authorized Official

Name: MRS. LYNNETTE BENJAMIN
Title or Position: HEALTH OFFICER
Credential: B.A.S.
Phone: 989-343-1800