Provider Demographics
NPI:1073837654
Name:PICKFORD MEDICAL CENTER
Entity Type:Organization
Organization Name:PICKFORD MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-643-0435
Mailing Address - Street 1:7742 N M 129
Mailing Address - Street 2:
Mailing Address - City:PICKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49774-9003
Mailing Address - Country:US
Mailing Address - Phone:906-647-2217
Mailing Address - Fax:
Practice Address - Street 1:220 BURDETTE ST
Practice Address - Street 2:
Practice Address - City:SAINT IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781-1712
Practice Address - Country:US
Practice Address - Phone:906-643-8585
Practice Address - Fax:906-643-0373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MACKINAC STRAITS HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health