| Intercare Community Health Network Dental Van | |
|
308 Charles Street Bangor MI 49013-1246 | |
| (269) 427-7937 | |
| (269) 427-5180 |
| Full Name | Intercare Community Health Network Dental Van |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 308 Charles Street, Bangor, Michigan |
| Authorized Official Name and Position | Velma Hendershott (CEO/PRESIDENT) |
| Authorized Official Contact | 2694277937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercare Community Health Network Dental Van 50 Industrial Park Rd Bangor MI 49013-1246 Ph: (269) 427-7937 | Intercare Community Health Network Dental Van 308 Charles Street Bangor MI 49013-1246 Ph: (269) 427-7937 |
| NPI Number | 1194133744 |
|---|---|
| Provider Enumeration Date | 07/28/2014 |
| Last Update Date | 07/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194133744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Bronson Lakeview Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 520 Railroad St, Bangor, MI 49013 Phone: 269-427-5811 Fax: 269-427-6107 | |
Intercare Community Heath Network Medical Van Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Charles Street, Bangor, MI 49013 Phone: 269-427-7937 Fax: 269-427-5180 | |
Intercare Community Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Industrial Park Dr, Bangor, MI 49013 Phone: 269-427-7937 Fax: 269-427-5180 | |
Bronson South Haven Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Railroad St, Bangor, MI 49013 Phone: 269-427-5811 Fax: 269-427-6107 | |
Intercare Community Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 308 Charles St, Bangor, MI 49013 Phone: 269-427-7967 Fax: 269-427-9539 |