| Randall Street Medical Pc | |
|
675 W Randall St Coopersville MI 49404-1305 | |
| (616) 837-9777 | |
| (616) 837-7813 |
| Full Name | Randall Street Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 675 W Randall St, Coopersville, Michigan |
| Authorized Official Name and Position | Roger Holman (OWNER/PHYSICIAN) |
| Authorized Official Contact | 6168379777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall Street Medical Pc 675 W Randall St Coopersville MI 49404-1305 Ph: (616) 837-9777 | Randall Street Medical Pc 675 W Randall St Coopersville MI 49404-1305 Ph: (616) 837-9777 |
| NPI Number | 1598734584 |
|---|---|
| Provider Enumeration Date | 03/14/2006 |
| Last Update Date | 07/22/2008 |
| Medicare PECOS PAC ID | 1951474246 |
|---|---|
| Medicare Enrollment ID | O20080721000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598734584 | NPI | - | NPPES |
| P57675 | Other | MI | BLUES HMO'S |
| 0027003 | Other | MI | PRIORITY HEALTH HMO |
| 4313667 | Medicaid | MI | |
| 005703574 | Other | MI | BCBSMI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 5101006733 (Michigan) | Primary |
Elite Medical Associates, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Main St, Coopersville, MI 49404 Phone: 616-268-9931 | |
Corewell Health Medical Group West Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 W Randall St, Coopersville, MI 49404 Phone: 616-974-4860 | |
Hardman Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Main St, Coopersville, MI 49404 Phone: 616-997-4023 Fax: 616-997-4025 | |
Corewell Health Medical Group West Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Conran Dr, Suite B, Coopersville, MI 49404 Phone: 616-267-7860 | |
Michigan Medical Patient Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 W Randall St, Coopersville, MI 49404 Phone: 616-974-4860 |