THUNDER BAY COMMUNITY HEALTH SERVICE, INC (NPI# 1750751392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750751392 |
| Entity Type | Organization |
| Organization Name | THUNDER BAY COMMUNITY HEALTH SERVICE, INC |
| Practice Address |
1110 8th Street Mio MI 48647-9140 |
| Mailing Address |
Po Box 427 Hillman MI 49746-0427 |
| Practice Telephone | 9898262400 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-27 |
| Authorized Official Name | MICHELLE STYMA (CEO) |
| Authorized Official Telephone | 9897424583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382677 | Thunder Bay Community Health Service, Inc | Clinic/Center | 609 W Central Ave Rm Tb1, Mackinaw City, MI 49701-9650 | 2019-12-05 |
| 1609435536 | Thunder Bay Community Health Service, Inc | Clinic/Center | 1033 W Huron Ave Rm Tb1, Rogers City, MI 49779-1428 | 2019-06-13 |
| 1952960197 | Thunder Bay Community Health Service, Inc | Clinic/Center | 311 N Washington St Rm Tb1, Hale, MI 48739-8516 | 2019-06-11 |
| 1750864112 | Thunder Bay Community Health Service, Inc | Clinic/Center | 5993 W Sholes St, Wolverine, MI 49799-9549 | 2018-09-12 |
| 1396292777 | Thunder Bay Community Health Service, Inc | Clinic/Center | 13131 Brook St, Wolverine, MI 49799-8406 | 2016-09-02 |
| 1558730234 | Thunder Bay Community Health Service, Inc | Clinic/Center | 1879 E Miller Rd, Fairview, MI 48621-8705 | 2015-09-23 |
| 1467837336 | Thunder Bay Community Health Service, Inc | Clinic/Center | 4363 S Straits Hwy, Indian River, MI 49749-9457 | 2015-07-21 |
| 1568846574 | Thunder Bay Community Health Service, Inc | Clinic/Center | 6800 Wilson Rd, Indian River, MI 49749-9447 | 2015-07-20 |
| 1124402136 | Thunder Bay Community Health Service, Inc | Clinic/Center | 4580 Montmorency St, Lewiston, MI 49756-7862 | 2015-07-20 |
| 1144603705 | Thunder Bay Community Health Service, Inc | Dentist | 26042 M 32 S, Hillman, MI 49746-9788 | 2015-07-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED | 15774 State St, Hillman, MI 49746-8818 |
| Street Address |
1110 8TH STREET |
| City | MIO |
| State | MI |
| Zip Code | 48647-9140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831480490 | Terrence Lee Krumbach | Pharmacist | 101 South Morenci, Rite Aid Discount Pharmacy #1715, Mio, MI 48647 | 2011-04-29 |
| 1588961502 | Debra K Alderton Pattullo | Counselor | 831 W. Miller Road, Mcog, Mio, MI 48647 | 2011-02-28 |
| 1982735999 | James Stephens Mangutz | Dentist | 107 E. Eighth St., Mio, MI 48647 | 2007-03-08 |
| 1053690438 | Mclaren Bay Region | Internal Medicine | 558 Lockwood Ln, Mio, MI 48647 | 2011-08-16 |
| 1467719252 | Michigan Physical Therapy, Inc. | Clinic/Center | 124 South Morenci Street, Mio, MI 48647-1032 | 2012-04-18 |
| 1063493989 | Pioneer Family Pharmacy Inc | Pharmacy | 114 South Morenci Ave, Mio, MI 48647-1060 | 2005-11-08 |
| 1700212479 | Family Fitness and Rehabilitation, LLC | Clinic/Center | 122 S Morenci Ave Ste A, Mio, MI 48647-2508 | 2013-09-25 |
| 1457644262 | Richard Daniel Graebner | Pharmacist | 101 S Morenci Ave, Mio, MI 48647-2508 | 2011-05-26 |
| 1164755187 | Angie A. Miller | Pharmacist | 114 S Morenci Ave, Mio, MI 48647-2508 | 2009-09-09 |
| 1043358393 | Michigan Institute of Rehabilitative Services, Inc | Clinic/Center | 122 S. Morenci Avenue, Mio, MI 48647-2508 | 2007-02-01 |
| Find all providers in zip 48647 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.