Organization
BARAGA COUNTY MEMORIAL HOSPITAL
Active
Other names
BCMH Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM ZWICKEY (CEO)
(906) 524-3322
Entity
Organization
Contact information
Practice address
18341 US HIGHWAY 41, LANSE, MI 49946-8024
(906) 524-6118
(906) 524-6218
Mailing address
18341 US HIGHWAY 41, LANSE, MI 49946-8024
(906) 524-6118
(906) 524-6218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801073221
MI
1041C0700X
Clinical Social Worker
6801073221
MI
207Q00000X
Family Medicine Physician
Primary
4301046352
MI
207Q00000X
Family Medicine Physician
4301053460
MI
207QA0401X
Addiction Medicine (Family Medicine) Physician
4301086536
MI
207R00000X
Internal Medicine Physician
4301078771
MI
208000000X
Pediatrics Physician
4301099797
MI
261QR1300X
Rural Health Clinic/Center
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841555430
RHC MEDICAID NPI
MI
01
—
238646
RHC PROVIDER NUMBER
MI
Enumeration date
07/10/2012
Last updated
03/21/2013
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