Organization
MECOSTA HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE SCHAFER (EXECUTIVE DIRECTOR)
(231) 592-4217
Entity
Organization
Contact information
Practice address
650 LINDEN ST, SUITE 1, BIG RAPIDS, MI 49307-1879
(231) 796-3200
(231) 796-5562
Mailing address
650 LINDEN ST, SUITE 1, BIG RAPIDS, MI 49307-1879
(231) 796-3200
(231) 796-5562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MI
208800000X
Urology Physician
—
MI
363A00000X
Physician Assistant
5601004630
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700E44551
BCBS GROUP NUMBER
MI
01
—
G02835
BCN/BLUE CHOICE GROUP NUM
MI
Enumeration date
06/04/2006
Last updated
07/21/2022
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