Provider Demographics
NPI:1750568549
Name:PHYSICIAN COVERAGE SERVICES P.C.
Entity type:Organization
Organization Name:PHYSICIAN COVERAGE SERVICES P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GAIL KROMER BILLER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KROMER
Authorized Official - Suffix:
Authorized Official - Credentials:BILLER
Authorized Official - Phone:810-235-2004
Mailing Address - Street 1:5494 S DORT HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-4483
Mailing Address - Country:US
Mailing Address - Phone:810-233-9901
Mailing Address - Fax:810-233-9915
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIAN COVERAGE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-24
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056750261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty