INTERCARE COMMUNITY HEALTH NETWORK (NPI# 1225334063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225334063 |
| Entity Type | Organization |
| Organization Name | INTERCARE COMMUNITY HEALTH NETWORK |
| Practice Address |
5498 109th Ave Pullman MI 49450-9631 |
| Mailing Address |
50 Industrial Park Rd Bangor MI 49013-1246 |
| Practice Telephone | 2692366330 |
| Practice Fax Number | 2692365411 |
| Mailing Telephone | 2694277937 |
| Mailing Fax Number | 2694275180 |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-01-26 |
| Authorized Official Name | VELMA HENDERSHOTT (PRESIDENT/CEO) |
| Authorized Official Telephone | 2694277937 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336701119 | Intercare Community Health Network | Counselor | 7450 Hochberger Rd Rm 15a, Eau Claire, MI 49111-9762 | 2019-07-02 |
| 1205363033 | Intercare Community Health Network | Clinic/Center | 796 Highway M-139, Benton Harbor, MI 49022-3881 | 2017-05-11 |
| 1891113353 | Intercare Community Health Network | Obstetrics & Gynecology | 50 Indusstrial Park Road, Bangor, MI 49013-1246 | 2014-04-02 |
| 1306064720 | Intercare Community Health Network | Clinic/Center | 540 South State Street, Sparta, MI 49345 | 2007-04-23 |
| 1699808881 | Intercare Community Health Network | Clinic/Center | 6270 W Main Street, Eau Claire, MI 49111 | 2007-03-14 |
| 1992818835 | Intercare Community Health Network | Clinic/Center | 308 Charles St, Bangor, MI 49013 | 2006-08-16 |
| 1326058512 | Intercare Community Health Network | Clinic/Center | 50 Industrial Park Dr, Bangor, MI 49013 | 2006-08-09 |
| 1205349990 | Intercare Community Health Network | Psychologist | 5498 109th Ave, Pullman, MI 49450-9631 | 2017-11-16 |
| 1902235328 | Intercare Community Health Network | Clinic/Center | 1485 M 139, Benton Harbor, MI 49022-5711 | 2013-11-06 |
| 1558506253 | Intercare Community Health Network | Clinic/Center | 870 Colfax Ave, Benton Harbor, MI 49022-7409 | 2008-12-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INTERCARE COMMUNITY HEALTH NETWORK | 50 Industrial Park Rd, Bangor, MI 49013-1246 |
| Street Address |
5498 109TH AVE |
| City | PULLMAN |
| State | MI |
| Zip Code | 49450-9631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710918883 | Renee K Hibma | Nurse Practitioner | 5498 109th Ave, Pullman, MI 49450 | 2006-07-06 |
| 1205349990 | Intercare Community Health Network | Psychologist | 5498 109th Ave, Pullman, MI 49450-9631 | 2017-11-16 |
| 1184030736 | Alejandra Kovac | Physician Assistant | 5498 109th Ave, Pullman, MI 49450-9631 | 2014-07-03 |
| 1184963639 | Carol Ann Mcbratnie | Nurse Practitioner | 5498 109th Ave, Pullman, MI 49450-9631 | 2013-02-04 |
| 1457361677 | Intercare Community Health Network | Clinic/Center | 5498 109th Ave, Pullman, MI 49450 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871529040 | Dean Alcorn | Dental Hygienist | 5498 109th Avenue, Pullman, MI 49450 | 2006-06-22 |
| 1134156029 | Kenneth Hite | Physician Assistant | 5498 109th Avenue, Pullman, MI 49450 | 2006-06-27 |
| 1831316306 | William T Parks IIi | Dentist | 5498 109th Avenue, Pullman, MI 49450-9631 | 2007-04-19 |
| 1174922439 | Teresa Marin | Rehabilitation Practitioner | 825 56th St, Pullman, MI 49450-9738 | 2014-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265049902 | Erin L Rose | Specialist/Technologist | 510 Nw Larry St, Pullman, WA 99163-3584 | 2020-09-27 |
| 1164039079 | Jalyn Rutledge | Specialist/Technologist | Bohler Athletic Complex Cougar Way - Wsu, Pullman, WA 99164-0001 | 2020-09-24 |
| 1851902605 | Northwest Clinical Services | Family Medicine | 825 Se Bishop Blvd Ste 301c, Pullman, WA 99163-5517 | 2020-08-14 |
| 1154949733 | Washington State University | Clinical Medical Laboratory | Bustad Hall Room 155n, Pullman, WA 99164-0001 | 2020-07-09 |
| 1669097127 | Dawnmd LLC | Family Medicine | 540 E Main St Ste A, Pullman, WA 99163-2660 | 2020-06-10 |
| 1801418504 | Savannah Horning | Specialist/Technologist | Bohler Athletic Complex Room M4, Pullman, WA 99164-0001 | 2020-05-15 |
| 1003445255 | Jennifer Beattie | Specialist/Technologist | 1360 Cougar Way, Pullman, WA 99163 | 2020-04-08 |
| 1114555133 | Lilly Paige Walker | Physical Medicine & Rehabilitation | 1624 Ne Cougar Way, Perham 126, Pullman, WA 99163-9916 | 2020-03-27 |
| 1689200099 | Tyler David Sykes | Dentist | 650 Se Bishop Blvd Ste 200, Pullman, WA 99163-5966 | 2020-03-17 |
| 1922632967 | Carlie Jean Lubbesmeyer | Specialist/Technologist | 1815 Wilson Road, Pullman, WA 99163-9916 | 2020-02-28 |
| Find all providers in PULLMAN | ||||
| 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 |
|---|---|---|---|---|
| 1457361677 | Intercare Community Health Network | Clinic/Center | 5498 109th Ave, Pullman, MI 49450 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1831706993 | Family Medical Center of Michigan, Inc | Clinic/Center | 503 Washington St Rm 150, Monroe, MI 48161-1309 | 2020-09-23 |
| 1326654666 | Family Medical Center of Michigan,inc | Clinic/Center | 550 E Main St Ste 1001, Hudson, MI 49247-9535 | 2020-09-22 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1700400389 | Northwest Michigan Health Services, Inc. | Clinic/Center | 300 W Broadway Ave Trlr 1, Scottville, MI 49454-1019 | 2020-05-30 |
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on INTERCARE COMMUNITY HEALTH NETWORK.
| 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.