Provider Demographics
NPI:1366525370
Name:PLANNED PARENTHOOD OF MICHIGAN
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:COVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-926-4821
Mailing Address - Street 1:950 VICTORS WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-926-4800
Mailing Address - Fax:734-973-0595
Practice Address - Street 1:3100 PROFESSIONAL DR.
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104
Practice Address - Country:US
Practice Address - Phone:734-973-0710
Practice Address - Fax:734-973-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X, 251V00000X, 261QA0005X, 261QF0050X
MI261Q00000X, 261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080H163430OtherBCBS
MI5085OtherCAPE
MI1000349OtherMCLAREN
MI234284761Medicaid
MI237005662Medicaid
MI9309000OtherPHP MID MICHIGAN
MI103223073Medicaid
MI234172228Medicaid
MI234284743Medicaid
MI234459330Medicaid
MI234284752Medicaid
MI234284770Medicaid
MI234897243Medicaid
MI003362OtherAA MIDWEST
MI003363OtherYP MIDWEST
MI234284761Medicaid