Randall Street Medical Pc in Coopersville - Rural Health
Randall Street Medical Pc - NPI 1598734584
Randall Street Medical Pc is a Rural Health in Coopersville, Michigan. Randall Street Medical Pc practices all healthcare services and medical treatments related to Rural Health. The NPI Number for Randall Street Medical Pc is 1598734584. The last update date is 2008-07-22.
Randall Street Medical Pc's current location address is 675 W Randall St, Coopersville, Michigan. You can contact this provider via phone number 6168379777 and fax number 6168377813. The mailing address for Randall Street Medical Pc is 675 W Randall St, Coopersville, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Randall Street Medical Pc |
|---|---|
| Address | 675 W Randall St, Coopersville, Michigan |
| Phone Number | 6168379777 |
| Fax Number | 6168377813 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PHYS |
|---|---|
| Authorized Official Name | Holman Roger |
| Credentials | D.O. |
| Telephone Number | 6168379777 |
NPI Number Detail
| NPI Number | 1598734584 |
|---|---|
| Provider Enumeration Date | 2006-03-14 |
| Last Updated Date | 2008-07-22 |
Provider Mailing Address Detail
| Address | 675 W Randall St |
|---|---|
| City | Coopersville |
| State | Michigan (MI) |
| Post Code | 494041305 |
| Phone Number | 6168379777 |
| Fax Number | 6168377813 |
Provider's Primary Taxonomy Detail
| Speciality | Rural Health |
|---|---|
| Taxonomy | 261Qr1300X |
| Licence No | 5101006733 |
|
Definition: Provides primary care and preventive health services in rural medically underserved areas. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P57675 | MI | BLUES HMO'S | |
| 27003 | MI | PRIORITY HEALTH HMO | |
| 4313667 | MI | -- | |
| 5703574 | MI | BCBSMI |
Post Comment/ Review Below
What is the Randall Street Medical Pc's unique identification number?
The Randall Street Medical Pc has been assigned the NPI (National Provider Identifier) Number 1598734584 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Randall Street Medical Pc?
The Randall Street Medical Pc is situated at 675 W Randall St, in the city of Coopersville, state of MI, with the zip code 494041305.
What is the area of specialization for Randall Street Medical Pc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Randall Street Medical Pc is Rural Health, and the corresponding taxonomy code that categorizes this area of expertise is 261Qr1300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1598734584 to Randall Street Medical Pc?
The Centers for Medicare & Medicaid Services originally issued the 1598734584 to Randall Street Medical Pc on 2006-03-14.
As of what date was the information regarding Randall Street Medical Pc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Randall Street Medical Pc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-07-22.