Organization
MARY FREE BED REHABILITATION HOSPITAL
Active
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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