Organization
INTERCARE COMMUNITY HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VELMA HENDERSHOTT (PRESIDENT/CEO)
(269) 427-7937
Entity
Organization
Contact information
Practice address
5498 109TH AVE, PULLMAN, MI 49450-9631
(269) 236-6330
(269) 236-5411
Mailing address
50 INDUSTRIAL PARK RD, BANGOR, MI 49013-1246
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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