Provider Demographics
NPI: | 1003904855 |
---|---|
Name: | WEST SHORE HEALTH CENTERS CORPORATION |
Entity Type: | Organization |
Organization Name: | WEST SHORE HEALTH CENTERS CORPORATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT, FINANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DONN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEMMER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 231-398-1188 |
Mailing Address - Street 1: | 1293 E PARKDALE AVE |
Mailing Address - Street 2: | STE 2300B |
Mailing Address - City: | MANISTEE |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49660-8904 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 231-398-1735 |
Mailing Address - Fax: | 231-398-1736 |
Practice Address - Street 1: | 1293 E PARKDALE AVE |
Practice Address - Street 2: | STE 2300B |
Practice Address - City: | MANISTEE |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49660-8904 |
Practice Address - Country: | US |
Practice Address - Phone: | 231-398-1735 |
Practice Address - Fax: | 231-398-1736 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-10 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty |