| Godwin Heights Middle School | |
|
100 Wexford St Se Rm 214 Wyoming MI 49548-2212 | |
| (616) 252-2070 | |
| Not Available |
| Full Name | Godwin Heights Middle School |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Wexford St Se Rm 214, Wyoming, Michigan |
| Authorized Official Name and Position | Tasha Blackmon (CEO) |
| Authorized Official Contact | 6169658215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Godwin Heights Middle School 100 Cherry St Se Grand Rapids MI 49503-4526 Ph: (616) 965-8200 | Godwin Heights Middle School 100 Wexford St Se Rm 214 Wyoming MI 49548-2212 Ph: (616) 252-2070 |
| NPI Number | 1104423508 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 6800707647 |
|---|---|
| Medicare Enrollment ID | O20201019002077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104423508 | NPI | - | NPPES |
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