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NPI Code Detail

MEDICARE: GREAT LAKES BAY HEALTH CENTERS

MEDICARE: GREAT LAKES BAY HEALTH CENTERS
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
1261QF0400XFederally Qualified Health Center (FQHC)MI

General Provider Information

NPI Number : 1790015279
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT LAKES BAY HEALTH CENTERS
Provider Business Mailing Address
First Line : 501 LAPEER
Second Line :
City : SAGINAW
State : MI
Zip : 48607-1208
Country : US
Telephone Number : 989-759-6464
Fax Number : 989-399-8233
Provider Business Practice Location Address
First Line : 6297 DIXIE HIGHWAY
Second Line :
City : BRIDGEPORT
State : MI
Zip : 48722-9635
Country : US
Telephone Number : 989-821-5390
Fax Number : 989-921-5389
Authorized Official
Title or Position : VICE PRESIDENT
Name : LISA GALONSKA
Credential :
Telephone Number : 989-759-6464
Provider Enumeration Date : 01/06/2010
Last Update Date : 09/27/2016

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Directions to “GREAT LAKES BAY HEALTH CENTERS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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