Provider Demographics
NPI:1861811382
Name:PETOSKEY URGENT CARE BILLING PC
Entity type:Organization
Organization Name:PETOSKEY URGENT CARE BILLING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:RACIGNOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-348-2828
Mailing Address - Street 1:1890 S US HIGHWAY 131 UNIT 4
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8344
Mailing Address - Country:US
Mailing Address - Phone:231-487-2000
Mailing Address - Fax:
Practice Address - Street 1:1890 S US HIGHWAY 131 UNIT 4
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8344
Practice Address - Country:US
Practice Address - Phone:231-487-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUICK CARE FAMILY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-11
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty