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NPI Code Detail

MEDICARE: HAMILTON COMMUNITY HEALTH NETWORK INC.

MEDICARE: HAMILTON COMMUNITY HEALTH NETWORK 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
1261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123-1940OTHERMIMEDICARE PART A

General Provider Information

NPI Number : 1922245299
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAMILTON COMMUNITY HEALTH NETWORK INC.
Provider Business Mailing Address
First Line : 225 E 5TH ST
Second Line : SUITE 300
City : FLINT
State : MI
Zip : 48502-1641
Country : US
Telephone Number : 810-406-4912
Fax Number : 810-424-6029
Provider Business Practice Location Address
First Line : 4154 W VIENNA RD
Second Line :
City : CLIO
State : MI
Zip : 48420-2809
Country : US
Telephone Number : 810-687-1008
Fax Number : 810-687-1951
Authorized Official
Title or Position : CEO
Name : MR. CLARENCE R. PIERCE
Credential : MSA
Telephone Number : 810-406-4912
Provider Enumeration Date : 01/08/2009
Last Update Date : 01/08/2021

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