Provider Demographics
NPI:1326197179
Name:LEELANAU URGENT CARE, PC
Entity Type:Organization
Organization Name:LEELANAU URGENT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEMAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:231-271-6511
Mailing Address - Street 1:650 S WEST BAY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:SUTTONS BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9587
Mailing Address - Country:US
Mailing Address - Phone:231-271-6511
Mailing Address - Fax:231-271-6519
Practice Address - Street 1:650 S WEST BAY SHORE DR
Practice Address - Street 2:
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-9587
Practice Address - Country:US
Practice Address - Phone:231-271-6511
Practice Address - Fax:231-271-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1336397538OtherNPI FOR ANDRIJ LAWRIN, PA
MI4500089Medicaid
MI1669563334OtherNPI FOR DAVID L LEMAK, MD
MI1902113475OtherNPI FOR ANDREA KNOKE, PAC
MI4500089Medicaid