Provider Demographics
NPI:1669567806
Name:PHYSICIAN COVERAGE SERVICES PC
Entity type:Organization
Organization Name:PHYSICIAN COVERAGE SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KROMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-235-2004
Mailing Address - Street 1:2700 ROBERT T LONGWAY BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2190
Mailing Address - Country:US
Mailing Address - Phone:810-235-2004
Mailing Address - Fax:810-235-2841
Practice Address - Street 1:2700 ROBERT T LONGWAY BLVD STE B
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2190
Practice Address - Country:US
Practice Address - Phone:810-235-2004
Practice Address - Fax:810-235-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty