GREAT LAKES BAY HEALTH CENTERS (NPI# 1073169835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073169835 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES BAY HEALTH CENTERS |
| Other Organization Name | GREAT LAKES BAY HEALTH CENTERS BRIDGEPORT SPAULDING HIGH SCHOOL |
| Practice Address |
4691 Bearcat Blvd Bridgeport MI 48722-9581 |
| Mailing Address |
501 Lapeer Ave Saginaw MI 48607-1203 |
| Practice Telephone | 9897770440 |
| Mailing Telephone | 9897596464 |
| Mailing Fax Number | 9893998233 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-26 |
| Authorized Official Name | DAWN CHRISTIAN (PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9897596464 |
| 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 |
| Other Name | Type Code |
|---|---|
| Great Lakes Bay Health Centers Bridgeport Spaulding High School | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1386290153 | Great Lakes Bay Health Centers | Clinic/Center | 3021 Court St, Saginaw, MI 48602-3620 | 2019-08-16 |
| 1275003766 | Great Lakes Bay Health Centers | Clinic/Center | 1821 Mckinley St, Bay City, MI 48708 | 2018-11-28 |
| 1275922411 | Great Lakes Bay Health Centers | Clinic/Center | 2110 S M 76 Ste 9, West Branch, MI 48661-8737 | 2015-01-12 |
| 1134491202 | Great Lakes Bay Health Centers | Clinic/Center | 1555 Industrial Drive, Owosso, MI 48867 | 2012-02-03 |
| 1902136385 | Great Lakes Bay Health Centers | Clinic/Center | 1015 Commerce Dr, Vassar, MI 48768-9589 | 2010-01-06 |
| 1023348406 | Great Lakes Bay Health Centers | Clinic/Center | 2424 N. Outer Drive, Saginaw, MI 48601-1208 | 2010-01-06 |
| 1649400284 | Great Lakes Bay Health Centers | Clinic/Center | 955 Commerce, Vassar, MI 48768-1208 | 2009-07-16 |
| 1548407992 | Great Lakes Bay Health Centers | Clinic/Center | 239 State Road, Suite A, Owosso, MI 48867-9075 | 2009-01-07 |
| 1548464951 | Great Lakes Bay Health Centers | Clinic/Center | 4800 Esch Road, Manchester Migrant Camp, Manchester, MI 48158 | 2007-06-12 |
| Street Address |
4691 BEARCAT BLVD |
| City | BRIDGEPORT |
| State | MI |
| Zip Code | 48722-9581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584305 | Ryan Abraham Labean | Behavior Technician | 6296 Village Square Drive, Suite 2, Bridgeport, MI 48722 | 2020-10-06 |
| 1760787360 | Melinda Eve Bierlein | Physical Therapist | 5460 W. Rolling Hills Drive, Bridgeport, MI 48722 | 2011-01-13 |
| 1376016261 | Guidepost Counseling Services, Pllc | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722 | 2019-01-03 |
| 1497098594 | Nicole Marie Judson | Physical Therapist | 5460 W Rolling Hills Dr, Bridgeport, MI 48722 | 2013-03-27 |
| 1659600377 | Kevin J Luptowski | Counselor | 6379 Dixie Hwy, Bridgeport, MI 48722 | 2009-12-08 |
| 1255472114 | Boettcher Home Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 6230 Dixie Hwy, Bridgeport, MI 48722-9513 | 2007-02-12 |
| 1356308480 | Bridgeport Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 6226 Dixie Hwy, Bridgeport, MI 48722-9513 | 2006-05-01 |
| 1114917242 | Bridgeport Pharmacy Inc | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2005-10-28 |
| 1922581131 | Midmichigan Rx Services LLC | Pharmacy | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-09-13 |
| 1184120990 | Hemang Vinodchandra Patel | Pharmacist | 6224 Dixie Hwy, Bridgeport, MI 48722-9513 | 2018-04-02 |
| Find all providers in zip 48722 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700252764 | Community Care of West Virginia, Inc. | Clinic/Center | 250 Worthington Dr, Bridgeport, WV 26330-1449 | 2015-08-13 |
| 1669868931 | Community Care of West Virginia, Inc. | Clinic/Center | 413 Johnson Ave, Bridgeport, WV 26330-1309 | 2015-04-13 |
| 1326434846 | Community Care of West Virginia, Inc. | Clinic/Center | 515 Johnston Avenue, Bridgeport, WV 26330-1311 | 2015-04-10 |
| 1912392358 | Community Care of West Virginia, Inc. | Clinic/Center | 531 Johnson Ave, Bridgeport, WV 26330-1311 | 2015-04-02 |
| 1497176390 | Family Health Centers | Clinic/Center | 1015 Columbia Ave, Bridgeport, WA 98813 | 2013-12-18 |
| 1235485236 | Optimus Health Care Inc | Clinic/Center | 3180 Main St Ste G1, Bridgeport, CT 06606-4237 | 2012-07-27 |
| 1346516317 | Optimus Health Care Inc | Clinic/Center | 1071 E Main St, Bridgeport, CT 06608-1618 | 2012-03-23 |
| 1619348844 | Community Care of West Virginia, Inc. | Clinic/Center | 65 Professional Pl Ste 102103, Bridgeport, WV 26330-0258 | 2015-10-14 |
| 1659641363 | Optimus Health Care Inc | Clinic/Center | 982 E Main St, Bridgeport, CT 06608-1913 | 2012-01-11 |
| 1932479409 | Optimus Health Care Inc | Clinic/Center | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2011-12-30 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 48722 |
Please comment or provide details below to improve the information on GREAT LAKES BAY HEALTH CENTERS.
| 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.