Baraga County Memorial Hospital
Organization Active NPI Family Medicine Physician · Lanse, MI
NPI 1700980968 · NPPES record last updated Aug 16, 2011
Key facts
- NPI
- 1700980968
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BARAGA COUNTY MEMORIAL HOSPITAL
- Practice address
- 18341 US Highway 41
Lanse, MI 49946-8024 - Phone
- (906) 524-6118
- Fax
- (906) 524-5126
- NPI assigned
- Sep 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Tim Zwickey
- Title
- Ceo
- Phone
- (906) 524-3321
Other NPIs on the same Medicare enrollment 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040826000560 | MI | Part B Supplier - Clinic/Group Practice | 7416866611 |
Receives reassigned benefits from 73 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lanse, MI |
National Provider Directory
Locations
18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
18341 US Highway 41
Lanse, MI 49946-8024
Mailing address
18341 US Highway 41
Lanse, MI 49946-8024
Phone (906) 524-6118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0Z71004 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 0Z71003 | Other | MI | BCBS GROUP ID |
Other names
- BCMH Physician Group
Other providers in Lanse, MI
- Baraga County Extended Care Corporation
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
- Baraga County Memorial Hospital
All providers in Lanse, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.