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General NPI Number Information
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NPI Number | 1306025523
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Entity Type | Organization
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Legal Business Name | OCEANA COUNTY MEDICAL CARE FACILITY
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 701 E MAIN ST
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City | HART
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State | MI
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Zip | 49420-1168
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Country | US
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Telephone | 231-873-6600
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Fax | 231-873-6030
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Provider Business Mailing Address
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Address Line | 701 E MAIN ST
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City | HART
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State | MI
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Zip | 49420-1168
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Country | US
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Telephone | 231-873-6600
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Fax | 231-873-6030
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GREGORY L WILSON
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Credential |
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Telephone | 231-873-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 648510
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License Number State | MI
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