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General NPI Number Information
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NPI Number | 1588650261
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Entity Type | Organization
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Legal Business Name | SYNANON INC
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1091 S BEACON BLVD
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2607
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Country | US
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Telephone | 616-604-0096
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Fax | 616-604-0095
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Provider Business Mailing Address
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Address Line | 1091 S BEACON BLVD
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2607
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Country | US
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Telephone | 616-604-0096
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Fax | 616-604-0095
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Authorized Official
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Title or Position | SR. VP OPERATIONS
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Name | JOHN FOSS
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Credential |
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Telephone | 231-861-3029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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