Basic Information
| Provider Information | |||||||||
| NPI: | 1730751660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CRITICAL CARE SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2973 ABRAMS DR | ||||||||
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| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939335220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103396949 | ||||||||
| FaxNumber: | 8104470482 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HURLEY PLZ | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485035902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102629000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2021 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | TERI | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 8102337103 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.