THUNDER BAY COMMUNITY HEALTH SERVICE INC NPI 1477591691

NPI Information

NPI: 1477591691
Provider Name: THUNDER BAY COMMUNITY HEALTH SERVICE, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 23D0381516

Address:
205 S BRANDLEY HWY
ROGERS CITY, MI
ZIP 49779
Phone: (989) 734-2052
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THUNDER BAY COMMUNITY HEALTH SERVICE, INC is a federally qualified health center (fqhc) clinic center in Rogers City, MI. THUNDER BAY COMMUNITY HEALTH SERVICE, INC NPI is 1477591691. The provider is registered as an organization entity type.

The provider's business location address is:

205 S BRANDLEY HWY
ROGERS CITY, MI
ZIP 49779
Phone: (989) 734-2052
Fax: (989) 734-7390

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 23D0381516 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/2/2006 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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0F060160	OTHER	MICHIGAN	MEDICARE BILL PAY TO

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: 4/28/2024

NPI Synchronization or Removal

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