GREAT LAKES HEALTH LLC NPI 1942621990

NPI Information

NPI: 1942621990
Provider Name: GREAT LAKES HEALTH, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2726 N SAGINAW RD
MIDLAND, MI
ZIP 48640
Phone: (989) 839-4560
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GREAT LAKES HEALTH, LLC is a primary care clinic center in Midland, MI. GREAT LAKES HEALTH, LLC NPI is 1942621990. The provider is registered as an organization entity type.

The provider's business location address is:

2726 N SAGINAW RD
MIDLAND, MI
ZIP 48640-633
Phone: (989) 839-4560
Fax: (989) 839-4565

The provider's authorized official is Sara Aileen Crawford .
The authorized official title is Owner/anp and has the following contact phone number (989) 839-4560.

The enumeration date for this NPI number is 12/18/2013 and was last updated on 4/2/2014.

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	261QP2300X	Clinic/Center	Primary Care	4704175287	MICHIGAN	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	Other Provider Identifier Issuer
1	P07470001	MEDICARE UPIN	MICHIGAN
2	1483761	MEDICAID	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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