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Organization
THREE RIVERS HEALTH AUTHORITY
Active
Organization
THREE RIVERS HEALTH AUTHORITY
Active
Other names
Three Rivers Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RUSSELL (CEO)
(269) 273-9601
Entity
Organization
Contact information
Practice address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 273-9789
(269) 273-9611
Mailing address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 278-1145
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
750020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N99470
MEDICARE - DIETICIAN GROUP
MI
05
—
1556456-30
—
MI
05
—
5172151-40
—
MI
Enumeration date
11/17/2005
Last updated
07/05/2011
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