| Great Lakes Health, Llc | |
|
2726 N Saginaw Rd Midland MI 48640-2633 | |
| (989) 839-4560 | |
| (989) 839-4565 |
| Full Name | Great Lakes Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2726 N Saginaw Rd, Midland, Michigan |
| Authorized Official Name and Position | Sara Aileen Crawford (OWNER/ANP) |
| Authorized Official Contact | 9898394560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Health, Llc 2726 N Saginaw Rd Midland MI 48640-2633 Ph: (989) 839-4560 | Great Lakes Health, Llc 2726 N Saginaw Rd Midland MI 48640-2633 Ph: (989) 839-4560 |
| NPI Number | 1942621990 |
|---|---|
| Provider Enumeration Date | 12/18/2013 |
| Last Update Date | 04/02/2014 |
| Medicare PECOS PAC ID | 8729219894 |
|---|---|
| Medicare Enrollment ID | O20140403000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942621990 | NPI | - | NPPES |
| 1483761 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4704175287 (Michigan) | Primary |
| Provider Name | Sara A Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285680223 PECOS PAC ID: 9537117262 Enrollment ID: I20050110000057 |
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