Organization
MARY FREE BED REHABILITATION HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN PODVIN (CHIEF FINANCIAL OFFICER)
(616) 840-8676
Entity
Organization
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0300
(616) 242-0438
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0300
(616) 242-0438
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
410070
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OM95520
MEDICARE PART B
MI
Enumeration date
02/06/2009
Last updated
01/27/2022
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