Provider Demographics
NPI:1871513622
Name:G. C. MEYER, INC.
Entity type:Organization
Organization Name:G. C. MEYER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:616-956-5556
Mailing Address - Street 1:1432 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-1682
Mailing Address - Country:US
Mailing Address - Phone:231-759-9161
Mailing Address - Fax:231-759-6492
Practice Address - Street 1:781 KENMOOR AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8628
Practice Address - Country:US
Practice Address - Phone:616-956-5556
Practice Address - Fax:616-956-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI510D116070OtherBLUE CROSS BLUE SHIELD MI
MI4254870Medicaid
MI3879100001Medicare NSC