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NPI Code Detail

MEDICARE: TRAVERSE HEALTH CLINIC AND COALITION

MEDICARE: TRAVERSE HEALTH CLINIC AND COALITION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1144178617
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRAVERSE HEALTH CLINIC AND COALITION
Provider Business Mailing Address
First Line : 1719 S GARFIELD AVE
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4337
Country : US
Telephone Number : 231-642-5813
Fax Number : 231-935-0962
Provider Business Practice Location Address
First Line : 1719 S GARFIELD AVE
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4337
Country : US
Telephone Number : 231-642-5813
Fax Number : 231-935-0962
Authorized Official
Title or Position : CEO
Name : CASEY KANDOW
Credential :
Telephone Number : 231-935-0799
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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1841296613 — LINDA RASMUSSEN M.S.N.
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1730153149 — MS. DONNA LAUREEN RINKER RN MSN BC-FNP
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1669441457 — ANNE M CAVANAGH M.D.
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1285792754 — ROGER K GERSTLE MD
Practice Location Address:
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1154531648 — MR. WILLIAM C FOWLE LMSW
Practice Location Address:
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49686-4337
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Practice Fax: 231-935-0962

Directions to “TRAVERSE HEALTH CLINIC AND COALITION ” Practice Location

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