Provider Demographics
NPI: | 1255305843 |
---|---|
Name: | MYMICHIGAN MEDICAL CENTER ALMA |
Entity Type: | Organization |
Organization Name: | MYMICHIGAN MEDICAL CENTER ALMA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER PATIENT ACCOUNTS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMANDA |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | PEIRCE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 989-356-7597 |
Mailing Address - Street 1: | 300 E WARWICK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | ALMA |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48801-1014 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 989-463-1101 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 300 E WARWICK DR |
Practice Address - Street 2: | |
Practice Address - City: | ALMA |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48801-1014 |
Practice Address - Country: | US |
Practice Address - Phone: | 989-463-1101 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-02-13 |
Last Update Date: | 2022-10-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 273R00000X | Hospital Units | Psychiatric Unit |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 00233 | Other | BCBSM |
MI | 73-1556330 | Medicaid | |
MI | 73-1556330 | Medicaid |