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General NPI Number Information
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NPI Number | 1437405172
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Entity Type | Organization
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Legal Business Name | MCLAREN THUMB REGION
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1040 S VAN DYKE RD
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City | BAD AXE
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State | MI
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Zip | 48413-9602
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Country | US
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Telephone | 989-269-9521
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Fax | 989-269-5260
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Provider Business Mailing Address
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Address Line | 1100 S VAN DYKE RD
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City | BAD AXE
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State | MI
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Zip | 48413-9615
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Country | US
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Telephone | 989-269-9521
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Fax | 989-269-5260
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Authorized Official
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Title or Position | VP/CFO
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Name | KENNETH BARANSKI
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Credential |
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Telephone | 989-269-1510
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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 | 1060000058
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License Number State | MI
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