Provider Demographics
NPI:1881679645
Name:STERLING AREA HEALTH CENTER
Entity Type:Organization
Organization Name:STERLING AREA HEALTH CENTER
Other - Org Name:OGEMAW CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUSHLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-654-2491
Mailing Address - Street 1:1827 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:MI
Mailing Address - Zip Code:48756-8626
Mailing Address - Country:US
Mailing Address - Phone:989-873-6200
Mailing Address - Fax:989-873-5563
Practice Address - Street 1:1827 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:MI
Practice Address - Zip Code:48756-8626
Practice Address - Country:US
Practice Address - Phone:989-873-6200
Practice Address - Fax:989-873-5563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STERLING AREA HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-14
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M83480Medicare PIN
MI231861Medicare Oscar/Certification