Provider Demographics
NPI:1669701124
Name:BEST KIDS PC
Entity type:Organization
Organization Name:BEST KIDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PASIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-300-2807
Mailing Address - Street 1:1107 STONE ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3569
Mailing Address - Country:US
Mailing Address - Phone:810-985-9300
Mailing Address - Fax:810-985-9393
Practice Address - Street 1:1107 STONE ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3569
Practice Address - Country:US
Practice Address - Phone:810-985-9300
Practice Address - Fax:810-985-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-12
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017094208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4977498Medicaid
MI4977498Medicaid
G46040112Medicare PIN