UPPER GREAT LAKES FAMILY HEALTH CENTER NPI 1104158690

NPI Information

NPI: 1104158690
Provider Name: UPPER GREAT LAKES FAMILY HEALTH CENTER

Doing Business As: GWINN FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 23D0382083

Address:
135 EAST M 35
GWINN, MI
ZIP 49841
Phone: (906) 346-9275
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UPPER GREAT LAKES FAMILY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Gwinn, MI. UPPER GREAT LAKES FAMILY HEALTH CENTER NPI is 1104158690. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gwinn Family Health Center.

The provider's business location address is:

135 EAST M 35
GWINN, MI
ZIP 49841-159
Phone: (906) 346-9275
Fax: (906) 346-5616

The provider's authorized official is Donald A Simila .
The authorized official title is Ceo and has the following contact phone number (906) 483-1325.

The CLIA number assigned to this NPI record is 23D0382083 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2010 and was last updated on 4/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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