| Mecosta County Medical Center | |
| 
					8354 100th Ave Ste 1 Canadian Lakes MI 49346-8345  | |
| (231) 972-6000 | |
| (231) 972-6003 | 
| Full Name | Mecosta County Medical Center | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 8354 100th Ave Ste 1, Canadian Lakes, Michigan | 
| Authorized Official Name and Position | Amanda Knuth (CONTROLLER) | 
| Authorized Official Contact | 2313491616 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mecosta County Medical Center 100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 Ph: (616) 486-6790  | Mecosta County Medical Center 8354 100th Ave Ste 1 Canadian Lakes MI 49346-8345 Ph: (231) 972-6000  | 
| NPI Number | 1477973493 | 
|---|---|
| Provider Enumeration Date | 04/17/2014 | 
| Last Update Date | 08/22/2023 | 
| Medicare PECOS PAC ID | 1951215540 | 
|---|---|
| Medicare Enrollment ID | O20130328000248 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1477973493 | NPI | - | NPPES | 
| 23-8667 | Other | CMS CERTIFICATION NUMBER | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |