Organization
FAMILY MEDICAL CENTER OF MICHIGAN,INC
Active
Other names
South Monroe County-Citizens' Health Council, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED LARKINS BA, MBA, MHA (CHIEF EXECUTIVE OFFICER)
(734) 850-6914
Entity
Organization
Contact information
Practice address
8765 LEWIS AVE, TEMPERANCE, MI 48182-9583
(734) 847-3802
(734) 850-0520
Mailing address
8765 LEWIS AVE, TEMPERANCE, MI 48182-9583
(734) 847-3802
(734) 850-0520
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02214
PARAMOUNT PROVIDER NUMBER
MI
01
—
18129
BCBSM FACILITY CODE
MI
Enumeration date
12/08/2006
Last updated
09/22/2020
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