# THREE RIVERS HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THREE RIVERS HEALTH SYSTEM, INC
- **Other names:** Three Rivers Health IMED
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821631334
- **Legal business name:** THREE RIVERS HEALTH SYSTEM, INC
- **Authorized official:** JEFFERY COSTELLO (CFO)
- **Authorized official phone:** (574) 647-3460

## Contact information

- **Practice address:** 16587 ENTERPRISE DR, THREE RIVERS, MI 49093-7902
- **Practice address phone:** (269) 279-6700
- **Practice address fax:** (269) 279-9612
- **Mailing address:** 3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/28/2019
- **Last updated:** 03/22/2026