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NPI Code Detail

MEDICARE: GLACIER HILLS INC.

MEDICARE: GLACIER HILLS INC.
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 Facility814110MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
209522OTHERMIBLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number : 1811936768
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLACIER HILLS INC.
Provider Business Mailing Address
First Line : 1200 EARHART RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2768
Country : US
Telephone Number : 734-769-6410
Fax Number : 734-769-5958
Provider Business Practice Location Address
First Line : 1200 EARHART RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2768
Country : US
Telephone Number : 734-769-6410
Fax Number : 734-769-5958
Authorized Official
Title or Position : VICE PRESIDENT REIMBURSEMENT
Name : PAMELA SUE LATOVICK
Credential :
Telephone Number : 734-343-6628
Provider Enumeration Date : 06/06/2006
Last Update Date : 09/11/2022

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Directions to “GLACIER HILLS INC. ” Practice Location

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