| Intercare Community Health Network | |
|
5498 109th Ave Pullman MI 49450 | |
| (269) 236-5021 | |
| (269) 236-5411 |
| Full Name | Intercare Community Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 5498 109th Ave, Pullman, Michigan |
| Authorized Official Name and Position | Velma Hendershott (PRESIDENT CEO) |
| Authorized Official Contact | 2694277937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercare Community Health Network 50 Industrial Park Dr Bangor MI 49013 Ph: (269) 427-7937 | Intercare Community Health Network 5498 109th Ave Pullman MI 49450 Ph: (269) 236-5021 |
| NPI Number | 1457361677 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 11/11/2011 |
| Medicare PECOS PAC ID | 9537061254 |
|---|---|
| Medicare Enrollment ID | O20040123000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457361677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Intercare Community Health Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5498 109th Ave, Pullman, MI 49450 Phone: 269-236-6330 Fax: 269-236-5411 |