| University of Michigan Health-sparrow | |
|
114 N Main St Ithaca MI 48847 | |
| (989) 875-4166 | |
| (989) 875-3600 |
| Full Name | University of Michigan Health-sparrow |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 N Main St, Ithaca, Michigan |
| Authorized Official Name and Position | Misty Gunter Russian (SUPERVISOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5172536308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University of Michigan Health-sparrow 8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (989) 584-3131 | University of Michigan Health-sparrow 114 N Main St Ithaca MI 48847 Ph: (989) 875-4166 |
| NPI Number | 1770553547 |
|---|---|
| Provider Enumeration Date | 01/25/2006 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Medicare PECOS PAC ID | 7113836701 |
|---|---|
| Medicare Enrollment ID | O20080520000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770553547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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