Organization
COUNTY OF SHIAWASSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE J PICHETTE JD (HEALTH OFFICER)
(989) 743-2318
Entity
Organization
Contact information
Practice address
110 E MACK ST, CORUNNA, MI 48817-1459
(989) 743-2356
(989) 743-2362
Mailing address
110 E MACK STREET, ATTN: ADMINISTRATION, CORUNNA, MI 48817-1440
(989) 743-2318
(989) 743-2357
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0982874
HEALTHPLUS COMMERCIAL
MI
05
—
0982874
—
MI
05
—
200000000547
—
MI
01
—
200000000548
PHYSICIANS HEALTH PLAN IM
MI
05
—
200000000548
—
MI
05
—
202916
—
MI
01
—
600G80600
BCBSM
MI
Enumeration date
06/10/2005
Last updated
04/14/2008
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