Provider Demographics
NPI:1245283977
Name:CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Entity type:Organization
Organization Name:CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-773-5921
Mailing Address - Street 1:2012 E PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8990
Mailing Address - Country:US
Mailing Address - Phone:989-773-5921
Mailing Address - Fax:989-773-4319
Practice Address - Street 1:2012 E PRESTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-8990
Practice Address - Country:US
Practice Address - Phone:989-773-5921
Practice Address - Fax:989-773-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2830352Medicaid
MI2830423Medicaid
MI5100199Medicaid
MI1862235Medicaid
MI2830399Medicaid
MI2830361Medicaid
MI2830343Medicaid
MI2830405Medicaid
MI5100152Medicaid
MI5100205Medicaid
MI5100214Medicaid
MI2830370Medicaid
MI5100161Medicaid
MI5100170Medicaid
MI5100161Medicaid
MI2830352Medicaid