Healthcare Provider Details
I. General information
NPI: 1245695584
Provider Name (Legal Business Name): DISTRICT HEALTH DEPARTMENT NO 10
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2015
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1049 E NEWELL ST
WHITE CLOUD MI
49349-8795
US
IV. Provider business mailing address
1049 E NEWELL ST PO BOX 850
WHITE CLOUD MI
49349-8795
US
V. Phone/Fax
- Phone: 231-689-7300
- Fax: 231-689-7360
- Phone: 231-689-7300
- Fax: 231-689-7360
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAWN
TAYLOR
Title or Position: BILLING COORDINATOR
Credential:
Phone: 231-355-7523