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General NPI Number Information
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NPI Number | 1235208075
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Entity Type | Organization
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Legal Business Name | NORTHWEST MICHIGAN HEALTH SERVICES INC.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 119 S STATE ST
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City | SHELBY
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State | MI
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Zip | 49455-1243
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Country | US
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Telephone | 231-861-2139
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Fax |
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Provider Business Mailing Address
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Address Line | 119 S STATE ST
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City | SHELBY
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State | MI
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Zip | 49455-1243
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Country | US
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Telephone | 231-861-2139
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | HEIDI MAE BRITTON
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Credential |
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Telephone | 231-947-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 5601004803
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License Number State | MI
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