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:
Authorized official contact:
Name: Lawrence-Friedl, Daryl M Doctor of Osteopathy (DO)
Phone: (616) 954-0402
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639382211 | NPPES |
| Michigan | MEDICAID | 1639382211 | |
| Michigan | Other | DH2054 | |
| Michigan | Other | 0D12216 |
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