Provider Demographics
NPI:1972732402
Name:PARTNERS IN HEALTH AT QUINCY INTERMED LLC
Entity type:Organization
Organization Name:PARTNERS IN HEALTH AT QUINCY INTERMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:517-639-5354
Mailing Address - Street 1:185 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MI
Mailing Address - Zip Code:49082-1165
Mailing Address - Country:US
Mailing Address - Phone:517-639-5354
Mailing Address - Fax:517-639-5344
Practice Address - Street 1:185 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MI
Practice Address - Zip Code:49082-1165
Practice Address - Country:US
Practice Address - Phone:517-639-5354
Practice Address - Fax:517-639-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4934955Medicaid
MI1932284973OtherTYPE 1 NPI
MI0P21870003Medicare PIN
MI1932284973OtherTYPE 1 NPI