Provider Demographics
NPI:1609427541
Name:BEAR RIVER PRIMARY CARE
Entity Type:Organization
Organization Name:BEAR RIVER PRIMARY CARE
Other - Org Name:MI BETTER HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-920-1100
Mailing Address - Street 1:2329 CENTER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BOYNE FALLS
Mailing Address - State:MI
Mailing Address - Zip Code:49713-9268
Mailing Address - Country:US
Mailing Address - Phone:231-758-4566
Mailing Address - Fax:
Practice Address - Street 1:829 W MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1998
Practice Address - Country:US
Practice Address - Phone:231-545-4140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty