Provider Demographics
NPI:1043430333
Name:DISTRICT HEALTH DEPARTMENT NO. 4
Entity Type:Organization
Organization Name:DISTRICT HEALTH DEPARTMENT NO. 4
Other - Org Name:FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRUNING
Authorized Official - Suffix:
Authorized Official - Credentials:RS MBA
Authorized Official - Phone:989-356-4507
Mailing Address - Street 1:100 WOODS CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1444
Mailing Address - Country:US
Mailing Address - Phone:989-356-4507
Mailing Address - Fax:989-356-3529
Practice Address - Street 1:100 WOODS CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1444
Practice Address - Country:US
Practice Address - Phone:989-356-4507
Practice Address - Fax:989-356-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101365Medicaid
MI5101374Medicaid