Provider Demographics
NPI:1720152275
Name:HAMILTON COMMUNITY HEALTH NETWORK INC.
Entity Type:Organization
Organization Name:HAMILTON COMMUNITY HEALTH NETWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:810-406-4912
Mailing Address - Street 1:225 E 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4912
Mailing Address - Fax:810-424-6029
Practice Address - Street 1:G3375 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1244
Practice Address - Country:US
Practice Address - Phone:810-743-6830
Practice Address - Fax:810-743-7086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2021-01-08
Deactivation Date:2008-04-30
Deactivation Code:
Reactivation Date:2008-09-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-1886OtherMEDICARE PART A
MI23-1886OtherMEDICARE PART A