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Midmichigan Health Services

Organization Active NPI Federally Qualified Health Center (FQHC) · Roscommon, MI

NPI 1033768700 · NPPES record last updated Sep 5, 2019

Key facts

NPI
1033768700
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
MIDMICHIGAN HEALTH SERVICES
Practice address
112 S 4TH St
Ste Medical
Roscommon, MI 48653-8904
Phone
(989) 422-5122
Fax
(989) 422-4378
NPI assigned
Sep 5, 2019
Organization subpart
No

Authorized official

Name
James P Raschke
Title
Ceo
Phone
(989) 422-2105

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2173915Northern Michigan Children'S Assessment Center
112 S 4TH St Ste Medical, Roscommon, MI 48653		Certificate of waiverOct 21, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

112 S 4TH St
Ste Medical
Roscommon, MI 48653-8904

Mailing address

9249 W Lake City Rd
Houghton Lake, MI 48629-9602
Phone (989) 422-5122

Other names

  • Northern Michigan Children's Assessment Center Doing business as

Other providers in Roscommon, MI

All providers in Roscommon, MI · Federally Qualified Health Center (FQHC) in Michigan

Sources for this page

Verify at the official NPI Registry.