TRAVERSE HEALTH CLINIC AND COALITION NPI 1831866821

NPI Information

NPI: 1831866821
Provider Name: TRAVERSE HEALTH CLINIC AND COALITION

Doing Business As: MOBILE MEDICAL VAN

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

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 23D2119736

Address:
1719 S GARFIELD AVE
TRAVERSE CITY, MI
ZIP 49686
Phone: (231) 935-0799
Get Directions

TRAVERSE HEALTH CLINIC AND COALITION is a federally qualified health center (fqhc) clinic center in Traverse City, MI. TRAVERSE HEALTH CLINIC AND COALITION NPI is 1831866821. The provider is registered as an organization entity type.
The provider Is Doing Business As Mobile Medical Van.

The provider's business location address is:

1719 S GARFIELD AVE
TRAVERSE CITY, MI
ZIP 49686-337
Phone: (231) 935-0799
Fax: (231) 935-0962

The provider's authorized official is Casey Kandow .
The authorized official title is Ceo and has the following contact phone number (231) 935-0799.

The CLIA number assigned to this NPI record is 23D2119736 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/26/2021 and was last updated on 7/12/2023.

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	343900000X	Non-emergency Medical Transport (VAN)				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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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