Provider Demographics
NPI:1376872341
Name:MYMICHIGAN MEDICAL CENTER CLARE
Entity Type:Organization
Organization Name:MYMICHIGAN MEDICAL CENTER CLARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
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 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:602 BEECH ST
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-1466
Practice Address - Country:US
Practice Address - Phone:989-802-5120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYMICHIGAN MEDICAL CENTER CLARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-21
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-8642OtherMEDICARE PTAN