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General NPI Number Information
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NPI Number | 1780601740
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Entity Type | Organization
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Legal Business Name | OAKLAND PRIMARY HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 46156 WOODWARD AVE SUITE B
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City | PONTIAC
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State | MI
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Zip | 48342-5033
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Country | US
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Telephone | 248-322-6747
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Fax | 248-322-5787
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Provider Business Mailing Address
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Address Line | 46156 WOODWARD AVE SUITE B
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City | PONTIAC
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State | MI
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Zip | 48342-5033
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Country | US
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Telephone | 248-322-6747
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Fax | 248-322-5787
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Authorized Official
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Title or Position | CFO
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Name | MS. SHARON BERRY
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Credential |
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Telephone | 248-322-6747
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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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