OrganizationBrookville Pediatric & Internal Medicine, PcPediatricsAllopathic & Osteopathic PhysiciansPractice Address1200 56th St SW, Wyoming, MI 49509(616) 243-5707PECOS EnrollmentBased on the most recent information from CMS, provider Brookville Pediatric & Internal Medicine, Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1346200847Provider TypeOrganizationFull NameBrookville Pediatric & Internal Medicine, PcSubpartNoEnumeration Date3/27/2006Last Updated4/7/2014Contact InformationPractice LocationPractice Address1200 56th St SW, Wyoming, MI 49509Phone(616) 243-5707Fax(616) 243-1170Mailing LocationMailing Address8485 Algoma Ave, Rockford, MI 49341Phone(616) 243-5707Fax(616) 243-1170Authorized OfficialNameKeizer, April A. (Administrative Manag)Phone(616) 514-3805Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerMichiganCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerMichigan