Provider Demographics
NPI:1326005109
Name:COUNTY OF BERRIEN MICHIGAN
Entity Type:Organization
Organization Name:COUNTY OF BERRIEN MICHIGAN
Other - Org Name:BERRIEN COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-927-5639
Mailing Address - Street 1:2149 EAST NAPIER AVENUE
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022
Mailing Address - Country:US
Mailing Address - Phone:269-926-7121
Mailing Address - Fax:269-926-8149
Practice Address - Street 1:2149 EAST NAPIER AVENUE
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022
Practice Address - Country:US
Practice Address - Phone:269-926-7121
Practice Address - Fax:269-926-8129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038022251K00000X
251K00000X, 261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI235100054Medicaid
MI311882425Medicaid
MI773520659Medicaid
MI774478021Medicaid
MI775057169Medicaid
MI235100063Medicaid
MI774077800Medicaid