Organization
EBSC, LLC
Active
Other names
Surgical Care Center of Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINE PATRICE KILGORE RN BSN (ADMINISTRATICE DIRECTOR)
(616) 580-6520
Entity
Organization
Contact information
Practice address
750 EAST BELTLINE NE, GRAND RAPIDS, MI 49525-6049
(616) 940-3600
(616) 954-0213
Mailing address
750 EAST BELTLINE NE, GRAND RAPIDS, MI 49525-6049
(616) 940-3600
(616) 954-0216
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490001454
MEDICARE RR
MI
Enumeration date
10/18/2006
Last updated
01/03/2021
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