Organization
BALDWIN FAMILY HEALTH CARE
Active
Parent organization
BALDWIN FAMILY HEALTH CARE
Other names
Pine River
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALDWIN FAMILY HEALTH CARE
Authorized official
JULIE TATKO (CEO)
(231) 745-2743
Entity
Organization
Contact information
Practice address
17445 PINE RIVER RD, LEROY, MI 49655
(231) 829-3841
(231) 829-9030
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-2743
(231) 745-5031
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D36000
BCBS GROUP ID
MI
Enumeration date
11/28/2016
Last updated
11/12/2020
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