Organization
LAUREL HEALTH CARE COMPANY OF WAYLAND
Active
Other names
THE LAURELS OF SANDY CREEK
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY PATTON (CFO)
(614) 794-8800
Entity
Organization
Contact information
Practice address
425 E ELM ST, WAYLAND, MI 49348-1109
(616) 792-2249
(616) 792-6121
Mailing address
425 E ELM ST, WAYLAND, MI 49348-1109
(616) 792-2249
(616) 792-6121
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
0340303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034030
NH LICENSE #
SC
05
—
3202091
—
MI
01
—
7105598
UNITED HEALTH CARE ID #
MI
Enumeration date
10/06/2006
Last updated
09/05/2007
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