# ST. JOHN HOSPITAL AND MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Masonic Urgent Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386892834
- **Authorized official:** JENNIFER JOHNSON (DIRECTOR)
- **Authorized official phone:** (586) 228-4560

## Contact information

- **Practice address:** 21099 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-1045
- **Practice address phone:** (586) 296-6213
- **Practice address fax:** (586) 296-8180
- **Mailing address:** 21099 MASONIC BLVD, SAINT CLAIR SHORES, MI 48082-1045
- **Mailing address phone:** (586) 296-6213
- **Mailing address fax:** (586) 296-8180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | MI | — |
| 261QU0200X | Urgent Care Clinic/Center | — | MI | Yes |

## Other

- **Enumeration date:** 09/08/2008
- **Last updated:** 12/12/2012