| Keweenaw Bay Indian Community | |
|
102 Superior Ave Baraga MI 49908-9673 | |
| (906) 353-4542 | |
| (906) 353-8799 |
| Full Name | Keweenaw Bay Indian Community |
|---|---|
| Speciality | Clinic/Center |
| Location | 102 Superior Ave, Baraga, Michigan |
| Authorized Official Name and Position | Joel Bruce Mills (MEDICAL BILLING CLERK) |
| Authorized Official Contact | 9063534542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keweenaw Bay Indian Community 102 Superior Ave Baraga MI 49908-9673 Ph: (906) 353-4542 | Keweenaw Bay Indian Community 102 Superior Ave Baraga MI 49908-9673 Ph: (906) 353-4542 |
| NPI Number | 1336232289 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 10/28/2010 |
| Medicare PECOS PAC ID | 7315070471 |
|---|---|
| Medicare Enrollment ID | O20101201000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336232289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 231845 (Michigan) | Primary |
Keweenaw Bay Indian Community D.a.lapointe Health Facility Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Superior Ave, Baraga, MI 49908 Phone: 906-353-4555 Fax: 906-353-8066 | |
Keweenaw Bay Indian Community Mihp Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Superior Ave, Baraga, MI 49908 Phone: 906-353-4542 Fax: 906-353-8799 |