| Northern Pines Health Center, Pc | |
|
11293 N M 37 Suite A Buckley MI 49620-9593 | |
| (231) 269-4185 | |
| (231) 269-4461 |
| Full Name | Northern Pines Health Center, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11293 N M 37, Buckley, Michigan |
| Authorized Official Name and Position | Mitzie J Hewitt (OWNER) |
| Authorized Official Contact | 2312694185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Pines Health Center, Pc 11293 N M 37 Suite A Buckley MI 49620-9593 Ph: (231) 269-4185 | Northern Pines Health Center, Pc 11293 N M 37 Suite A Buckley MI 49620-9593 Ph: (231) 269-4185 |
| NPI Number | 1578547071 |
|---|---|
| Provider Enumeration Date | 11/30/2005 |
| Last Update Date | 03/24/2021 |
| Medicare PECOS PAC ID | 0446161251 |
|---|---|
| Medicare Enrollment ID | O20030724000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578547071 | NPI | - | NPPES |
| 4513149 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 305R00000X | Preferred Provider Organization | 5101013101 (Michigan) | Secondary |