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Organization

COUNTY OF INGHAM

Active
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Organization

COUNTY OF INGHAM

Active
Other names
Gardner Community Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
ADENIKE TOLULUPE SHOYINKA (OA - MEDICAL HEALTH OFFICER)
(517) 887-4466
Entity
Organization

Contact information

Practice address
333 DAHLIA DR RM E315, LANSING, MI 48911-3789
(517) 272-4115
Mailing address
PO BOX 30161, LANSING, MI 48909-7661
(517) 887-4383
(517) 244-7174

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0C36051
MEDICARE PIN
MI
01
0M77560
MEDICARE PIN
MI
01
231155
PTAN
MI
Enumeration date
05/22/2019
Last updated
10/15/2025
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