Provider Demographics
NPI:1003904855
Name:WEST SHORE HEALTH CENTERS CORPORATION
Entity type:Organization
Organization Name:WEST SHORE HEALTH CENTERS CORPORATION
Other - Org Name:
Other - Org Type:
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:STE 2300B
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-8904
Mailing Address - Country:US
Mailing Address - Phone:231-398-1735
Mailing Address - Fax:231-398-1736
Practice Address - Street 1:1293 E PARKDALE AVE
Practice Address - Street 2:STE 2300B
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-8904
Practice Address - Country:US
Practice Address - Phone:231-398-1735
Practice Address - Fax:231-398-1736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty