Ada Village Medical

LBN: West Michigan Family Practice, Pc
Ada Village Medical is an health care organization with primary practice located at 877 Forest Hill Ave Se Suite C, Grand Rapids MI 49546-2380. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is the primary health care specialty. West Michigan Family Practice, Pc can be contacted via phone (616) 954-0402, or through Lawrence-Friedl, Daryl M via phone (616) 954-0402.

Contact Information

Primary practice address
877 Forest Hill Ave Se Suite C Grand Rapids MI 49546-2380
Phone: (616) 954-0402
Fax: (616) 954-0404
Website:
Map and Directions
Authorized official contact:
Name: Lawrence-Friedl, Daryl M Doctor of Osteopathy (DO)
Phone: (616) 954-0402

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5101010305 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101010305 Michigan

Profile Details

NPI number 1639382211
LBN Legal business name West Michigan Family Practice, Pc
DBA Doing business as Ada Village Medical
Authorized official Lawrence-Friedl, Daryl M Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date May 8th, 2007
Last updated Oct 22nd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639382211 NPPES
Michigan MEDICAID 1639382211
Michigan Other DH2054
Michigan Other 0D12216

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