Provider Demographics
NPI:1982768032
Name:BARRY-EATON DISTRICT HEALTH
Entity Type:Organization
Organization Name:BARRY-EATON DISTRICT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRIMGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-541-2602
Mailing Address - Street 1:1033 HEALTHCARE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1058
Mailing Address - Country:US
Mailing Address - Phone:517-543-2430
Mailing Address - Fax:517-543-2656
Practice Address - Street 1:1033 HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1058
Practice Address - Country:US
Practice Address - Phone:517-543-2430
Practice Address - Fax:517-543-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P28320OtherMEDICARE MASS IMMUNIZATION
MI0N97350OtherMEDICARE PTAN
MIP00297302OtherRAILROAD RETIREMENT
MI5100027Medicaid
MI1845717Medicaid