Organization
LUCE-MACKINAC HEALTH DEPARTMENT
Active
Organization
LUCE-MACKINAC HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS P DERUSHA (HEALTH OFFICER)
(906) 293-5107
Entity
Organization
Contact information
Practice address
14150 HAMILTON LAKE ROAD, NEWBERRY, MI 49868
(906) 293-5107
(906) 293-5453
Mailing address
14150 HAMILTON LAKE ROAD, NEWBERRY, MI 49868
(906) 293-5107
(906) 293-5453
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1498334
—
MI
05
—
1850341
—
MI
05
—
2789120
—
MI
05
—
2789130
—
MI
05
—
2789149
—
MI
05
—
5100573
—
MI
05
—
5100582
—
MI
05
—
5100591
—
MI
05
—
5100608
—
MI
Enumeration date
03/02/2007
Last updated
08/29/2012
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