Organization
MECOSTA COUNTY MEDICAL CENTER
Active
Other names
Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes, Spectrum Health Big Rapids Canadian Lakes Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KNUTH (CONTROLLER)
(231) 349-1616
Entity
Organization
Contact information
Practice address
8354 100TH AVE STE 1, CANADIAN LAKES, MI 49346-8345
(231) 972-6000
(231) 972-6003
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-8667
CMS CERTIFICATION NUMBER
—
Enumeration date
04/17/2014
Last updated
08/22/2023
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