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NPI Code Detail

MEDICARE: SCHOOLCRAFT MEDICAL CARE FACILITY

MEDICARE: SCHOOLCRAFT MEDICAL CARE FACILITY
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
1314000000XSkilled Nursing Facility778510MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356348114
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCHOOLCRAFT MEDICAL CARE FACILITY
Provider Business Mailing Address
First Line : 520 MAIN ST
Second Line :
City : MANISTIQUE
State : MI
Zip : 49854-1522
Country : US
Telephone Number : 906-341-6921
Fax Number : 906-341-6213
Provider Business Practice Location Address
First Line : 520 MAIN ST
Second Line :
City : MANISTIQUE
State : MI
Zip : 49854-1522
Country : US
Telephone Number : 906-341-6921
Fax Number : 906-341-6213
Authorized Official
Title or Position : ADMINISTRATOR
Name : TONYA SUE LEIK
Credential :
Telephone Number : 906-341-6921
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/20/2016

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Directions to “SCHOOLCRAFT MEDICAL CARE FACILITY ” Practice Location

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