Organization
GOGEBIC MEDICAL CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E DUNN (ADMINISTRATOR)
(906) 224-9811
Entity
Organization
Contact information
Practice address
402 NORTH ST, WAKEFIELD, MI 49968-9452
(906) 224-9811
(906) 224-1086
Mailing address
402 NORTH ST, WAKEFIELD, MI 49968-9452
(906) 224-9811
(906) 224-1086
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
278510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09614
BLUE CROSS/BLUE SHIELD
MI
05
—
2084190
—
MI
Enumeration date
08/23/2005
Last updated
11/14/2011
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