Provider Demographics
NPI:1851436315
Name:WEST SHORE HEALTH CENTERS CORPORATION
Entity Type:Organization
Organization Name:WEST SHORE HEALTH CENTERS CORPORATION
Other - Org Name:EDWARDO BARLAN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DONN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-398-1188
Mailing Address - Street 1:1293 E PARKDALE AVE
Mailing Address - Street 2:SUITE 2300 A
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-8904
Mailing Address - Country:US
Mailing Address - Phone:231-398-1740
Mailing Address - Fax:
Practice Address - Street 1:1293 E PARKDALE AVE
Practice Address - Street 2:SUITE 2300 A
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-8904
Practice Address - Country:US
Practice Address - Phone:231-398-1740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty