GLADWIN FAMILY CARE CENTER P C NPI 1104931211

NPI Information

NPI: 1104931211
Provider Name: GLADWIN FAMILY CARE CENTER P C
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
2137 W M61
GLADWIN, MI
ZIP 48624
Phone: (989) 426-9399
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GLADWIN FAMILY CARE CENTER P C is a health service clinic center in Gladwin, MI. GLADWIN FAMILY CARE CENTER P C NPI is 1104931211. The provider is registered as an organization entity type.

The provider's business location address is:

2137 W M61
GLADWIN, MI
ZIP 48624
Phone: (989) 426-9399
Fax: (989) 246-2257

The provider's authorized official is Hicham Churbaji .
The authorized official title is President and has the following contact phone number (989) 426-9399.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 11/1/2007.

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	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	I65729	MEDICARE UPIN	MICHIGAN
2	5214752	MEDICAID	MICHIGAN
3	Q79514	MEDICARE UPIN	MICHIGAN
4	0N89940	MEDICARE PIN	MICHIGAN
5	E00476	MEDICARE UPIN	MICHIGAN
6	0P01150	MEDICARE PIN	MICHIGAN
7	5203202	MEDICAID	MICHIGAN
8	7116734	MEDICAID	MICHIGAN
9	I60516	MEDICARE UPIN	MICHIGAN
10	4276035	MEDICAID	MICHIGAN
11	H22298	MEDICARE UPIN	MICHIGAN
12	4920566	MEDICAID	MICHIGAN
13	H75707	MEDICARE UPIN	MICHIGAN
14	4989200	MEDICAID	MICHIGAN
15	P41150	MEDICARE UPIN	MICHIGAN

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

NPI Synchronization or Removal

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