MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS (NPI# 1952685588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952685588 |
| Entity Type | Organization |
| Organization Name | MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS |
| Other Organization Name | GUN LAKE TRIBE |
| Practice Address |
2880 Mission Dr Shelbyville MI 49344-9580 |
| Mailing Address |
2880 Mission Drive Shelbyville MI 49344 |
| Practice Telephone | 2693971760 |
| Practice Fax Number | 2693971763 |
| Mailing Telephone | 2693971760 |
| Mailing Fax Number | 2693971763 |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2017-05-08 |
| Authorized Official Name | MS. KELLY WESAW (HEALTH DIRECTOR) |
| Authorized Official Telephone | 2693971760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Gun Lake Tribe | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689232241 | Match-e-be-nash-she-wish Band of Pottawatomi Indians | Pharmacy | 2880 Mission Dr, Shelbyville, MI 49344-9580 | 2019-05-30 |
| Street Address |
2880 MISSION DR |
| City | SHELBYVILLE |
| State | MI |
| Zip Code | 49344-9580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689232241 | Match-e-be-nash-she-wish Band of Pottawatomi Indians | Pharmacy | 2880 Mission Dr, Shelbyville, MI 49344-9580 | 2019-05-30 |
| 1619328879 | Kelsey Mosher | Pharmacist | 2880 Mission Dr, Shelbyville, MI 49344 | 2016-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972670248 | Daniel Joe Lavengood | Chiropractor | 11925 Marsh Rd, Shelbyville, MI 49344 | 2006-11-29 |
| 1902970668 | Great Lakes R.ph. Corp | Durable Medical Equipment & Medical Supplies | 71 124th Ave, Shelbyville, MI 49344 | 2006-11-17 |
| 1871030122 | Bobbi Keyzer | Registered Nurse | 972 129th Ave, Shelbyville, MI 49344-9509 | 2017-01-25 |
| 1578961868 | Misty Wuis | Licensed Practical Nurse | 2423 Pearl St, Shelbyville, MI 49344-9700 | 2014-12-18 |
| 1750731972 | Elizabeth Spaulding | Technician, Other | 2535 7th St Apt 6, Shelbyville, MI 49344-9761 | 2016-06-18 |
| 1023017456 | Great Lakes Rph | Pharmacy | 71 124th Ave, Shelbyville, MI 49344-9772 | 2005-07-18 |
| 1679573364 | Michael A Holtz | Pharmacist | 71 124th Ave, Shelbyville, MI 49344-9772 | 2005-07-26 |
| 1053941088 | Camille Woolf Irvine | Dietitian, Registered | 5419 Fawn Lake Dr, Shelbyville, MI 49344-9780 | 2020-01-17 |
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093365835 | Sacred Heart Rehabilitation Center | Clinic/Center | 22256 Marine Ave, Eastpointe, MI 48021-2634 | 2019-09-13 |
| 1124677265 | Sacred Heart Rehabilitation Center | Clinic/Center | 23099 David Ave, Eastpointe, MI 48021-1826 | 2019-09-11 |
| 1699324731 | Sacred Heart Rehabilitation Center | Clinic/Center | 1504 E Greig Ave, Madison Heights, MI 48071-3826 | 2019-09-11 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1376100479 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd, D - 5, Community Health, Southfield, MI 48033-3849 | 2019-05-23 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1013410596 | Our Wellness Hub | Clinic/Center | 17401 E 10 Mile Rd, Eastpointe, MI 48021-1256 | 2018-03-12 |
| 1235648700 | Sacred Heart Rehabilitation Center | Clinic/Center | 329 Butternut St, Benton Harbor, MI 49022-2922 | 2017-09-27 |
| 1326427162 | Holistic Healer & Wellness Center Inc | Clinic/Center | 3998 Clippert St, Dearborn Hts, MI 48125-2731 | 2015-05-27 |
| Find all providers with the same taxonomy | ||||
| City | SHELBYVILLE |
| Zip Code | 49344 |
Please comment or provide details below to improve the information on MATCH-E-BE-NASH-SHE-WISH BAND OF POTTAWATOMI INDIANS.
| 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.