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 3 days ago.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