Provider Demographics
NPI:1043343759
Name:EMERGENCY MEDICAL CENTRE OF FLINT, INC.
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL CENTRE OF FLINT, INC.
Other - Org Name:GMC PC DBA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:810-733-9925
Mailing Address - Street 1:2284 S BALLENGER HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3446
Mailing Address - Country:US
Mailing Address - Phone:810-232-6101
Mailing Address - Fax:810-232-4925
Practice Address - Street 1:2284 S BALLENGER HWY
Practice Address - Street 2:STE 2
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3446
Practice Address - Country:US
Practice Address - Phone:810-232-6101
Practice Address - Fax:810-232-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0B56056Medicare PIN