MEDICARE: FAMILY FIRST HEALTH CARE-YALE, PLLC

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
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0P14810	OTHER	MI	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0G60086	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1790139475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FIRST HEALTH CARE-YALE, PLLC

Provider Business Mailing Address
First Line	:	5730 MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	MI
Zip	:	48450-8800
Country	:	US
Telephone Number	:	810-696-2088
Fax Number	:	810-696-2094

Provider Business Practice Location Address
First Line	:	5730 MAIN ST
Second Line	:
City	:	LEXINGTON
State	:	MI
Zip	:	48450-8800
Country	:	US
Telephone Number	:	810-696-2088
Fax Number	:	810-696-2094

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT MCPHILIMY
Credential	:	D.O.
Telephone Number	:	810-387-9355

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	08/02/2016

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Directions to “FAMILY FIRST HEALTH CARE-YALE, PLLC ” Practice Location

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