Provider Demographics
NPI:1982895587
Name:NEWAYGO COUNTY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:NEWAYGO COUNTY COMMUNITY SERVICES
Other - Org Name:NCCS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEV
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-924-0641
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-0149
Mailing Address - Country:US
Mailing Address - Phone:231-924-0641
Mailing Address - Fax:231-924-5594
Practice Address - Street 1:6308 S WARNER AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-9279
Practice Address - Country:US
Practice Address - Phone:231-924-0641
Practice Address - Fax:231-924-5594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies