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General NPI Number Information
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NPI Number | 1053329086
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Entity Type | Organization
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Legal Business Name | MCLAREN CENTRAL MICHIGAN
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 5115 E PICKARD ST
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City | MT PLEASANT
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State | MI
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Zip | 48858-5006
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Country | US
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Telephone | 989-956-4100
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Fax | 989-956-4105
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Provider Business Mailing Address
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Address Line | 1221 SOUTH DR
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City | MT PLEASANT
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State | MI
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Zip | 48858-3258
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Country | US
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Telephone | 989-772-6700
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Fax | 989-772-6807
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Authorized Official
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Title or Position | VP/CFO
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Name | TARA SOULES
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Credential |
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Telephone | 989-772-6720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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