Provider Demographics
NPI:1942532197
Name:COUNTY OF MACOMB
Entity Type:Organization
Organization Name:COUNTY OF MACOMB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-465-8322
Mailing Address - Street 1:22550 HALL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1189
Mailing Address - Country:US
Mailing Address - Phone:586-469-5769
Mailing Address - Fax:586-469-7958
Practice Address - Street 1:43740 N GROESBECK HWY
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-1139
Practice Address - Country:US
Practice Address - Phone:586-469-7929
Practice Address - Fax:586-469-7664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI260E07664OtherREGULAR BUSINESS BC
MI3396315Medicaid
MI750910560OtherBC OPC
MI750911560OtherBC OPC
MI750912560OtherBC OPC
MI750913560OtherBC OPC
MI0E06125Medicare PIN
MI0Q26321Medicare PIN