Provider Demographics
NPI:1457827776
Name:PHYSICIAN COVERAGE SERVICES
Entity Type:Organization
Organization Name:PHYSICIAN COVERAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KROMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-235-2004
Mailing Address - Street 1:2700 ROBERT T LONGWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2190
Mailing Address - Country:US
Mailing Address - Phone:810-235-2004
Mailing Address - Fax:810-235-2841
Practice Address - Street 1:G2065 S CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-1101
Practice Address - Country:US
Practice Address - Phone:810-235-2004
Practice Address - Fax:810-235-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty