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General NPI Number Information
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NPI Number | 1467092528
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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 | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 920 DIANA ST STE 100
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City | LUDINGTON
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State | MI
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Zip | 49431-1987
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Country | US
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Telephone | 231-845-6294
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Fax |
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Provider Business Mailing Address
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Address Line | 10767 E TRAVERSE HWY
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-6219
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Country | US
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Telephone | 231-947-1112
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Fax | 231-947-7739
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Authorized Official
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Title or Position | BILLER
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Name | BEVERLY UHELSKI
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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