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Organization

THUNDER BAY COMMUNITY HEALTH SERVICE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD BATES (INTERIM CEO)
(989) 742-4583
Entity
Organization

Contact information

Practice address
205 S BRANDLEY HWY, ROGERS CITY, MI 49779
(989) 734-2052
(989) 734-7390
Mailing address
PO BOX 427, HILLMAN, MI 49746-0427
(989) 742-4583
(989) 742-4298

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F060160
MEDICARE BILL PAY TO
MI
Enumeration date
06/02/2006
Last updated
03/13/2023
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