# THREE RIVERS HEALTH SYSTEM, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THREE RIVERS HEALTH SYSTEM, INC
- **Other names:** Kalamazoo Foot & Ankle Specialists
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992197925
- **Legal business name:** THREE RIVERS HEALTH SYSTEM, INC
- **Authorized official:** JEFFERY COSTELLO (CFO)
- **Authorized official phone:** (574) 647-3460

## Contact information

- **Practice address:** 7971 MOORSBRIDGE RD, PORTAGE, MI 49024-4075
- **Practice address phone:** (269) 323-2094
- **Practice address fax:** (269) 323-2095
- **Mailing address:** 3245 HEALTH DR STE 100, GRANGER, IN 46530-1380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 02/27/2015
- **Last updated:** 07/22/2024