Organization
MCLAREN BAY REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE C JACKS PORTER (VP/CFO)
(989) 894-3838
Entity
Organization
Contact information
Practice address
1900 COLUMBUS AVE, BAY CITY, MI 48708
(989) 894-3000
(989) 891-8172
Mailing address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6831
(989) 894-3000
(989) 891-8172
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00004
BCBSM PROVIDER NUMBER
MI
05
—
1528031226
—
MI
01
—
1556302
MEDICAID PROVIDER NUMBER
MI
01
—
230041
MEDICARE PROVIDER NUMBER
MI
01
—
5170101
MEDICAID PROVIDER NUMBER
MI
Enumeration date
02/12/2006
Last updated
07/21/2020
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