| Thunder Bay Community Health Service, Inc | |
|
10854 M 32 E Johannesburg MI 49751-9622 | |
| (989) 354-2197 | |
| (989) 356-6524 |
| Full Name | Thunder Bay Community Health Service, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10854 M 32 E, Johannesburg, Michigan |
| Authorized Official Name and Position | Richard Bates (INTERIM CEO) |
| Authorized Official Contact | 9897314420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thunder Bay Community Health Service, Inc Po Box 427 Hillman MI 49746-0427 Ph: () - | Thunder Bay Community Health Service, Inc 10854 M 32 E Johannesburg MI 49751-9622 Ph: (989) 354-2197 |
| NPI Number | 1760864763 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 03/13/2023 |
| Medicare PECOS PAC ID | 0143296772 |
|---|---|
| Medicare Enrollment ID | O20220316000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760864763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |