| Primary Healthcare Michigan Plc | |
|
5092 W Vienna Rd Ste G Clio MI 48420-2804 | |
| (810) 686-2212 | |
| Not Available |
| Full Name | Primary Healthcare Michigan Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 5092 W Vienna Rd Ste G, Clio, Michigan |
| Authorized Official Name and Position | Pauline Aquino (OWNER) |
| Authorized Official Contact | 8106862212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Healthcare Michigan Plc 5092 W Vienna Rd Ste G Clio MI 48420-2804 Ph: () - | Primary Healthcare Michigan Plc 5092 W Vienna Rd Ste G Clio MI 48420-2804 Ph: (810) 686-2212 |
| NPI Number | 1023521192 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 11/13/2017 |
| Medicare PECOS PAC ID | 2163782137 |
|---|---|
| Medicare Enrollment ID | O20180213000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023521192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Pauline C Aquino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356370407 PECOS PAC ID: 5193790111 Enrollment ID: I20040901000598 |
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