Provider Demographics
NPI:1245257880
Name:MCLAREN THUMB REGION
Entity type:Organization
Organization Name:MCLAREN THUMB REGION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-269-1510
Mailing Address - Street 1:1100 S VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-9615
Mailing Address - Country:US
Mailing Address - Phone:989-269-9521
Mailing Address - Fax:989-269-5216
Practice Address - Street 1:1100 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-9615
Practice Address - Country:US
Practice Address - Phone:989-269-9521
Practice Address - Fax:989-269-5216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCLAREN THUMB REGION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320020282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4621253Medicaid
MI4320035Medicaid
MI4427381Medicaid
MI4697019Medicaid
MI4776669Medicaid
MI4827347Medicaid
MI010C260080OtherBCBS ER PROFESSIONAL
MI4427480Medicaid
MI4543273Medicaid
MI4543273Medicaid