THUNDER BAY COMMUNITY HEALTH SERVICE INC NPI 1558730234

NPI Information

NPI: 1558730234
Provider Name: THUNDER BAY COMMUNITY HEALTH SERVICE, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 23D2213965

Address:
1879 E MILLER RD
FAIRVIEW, MI
ZIP 48621
Phone: (989) 848-7004
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THUNDER BAY COMMUNITY HEALTH SERVICE, INC is a federally qualified health center (fqhc) clinic center in Fairview, MI. THUNDER BAY COMMUNITY HEALTH SERVICE, INC NPI is 1558730234. The provider is registered as an organization entity type.

The provider's business location address is:

1879 E MILLER RD
FAIRVIEW, MI
ZIP 48621-705
Phone: (989) 848-7004

The provider's authorized official is Richard Bates .
The authorized official title is Interim Ceo and has the following contact phone number (989) 742-4583.

The CLIA number assigned to this NPI record is 23D2213965 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2015 and was last updated on 3/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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