Organization
THREE RIVERS HEALTH NUTRITIONAL SERVICES
Active
Parent organization
THREE RIVERS HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
THREE RIVERS HEALTH
Authorized official
WILLIAM RUSSELL (CEO/PRESIDENT)
(269) 273-9601
Entity
Organization
Contact information
Practice address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
(269) 273-9611
Mailing address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
750020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N99470
MEDICARE GROUP PIN
MI
Enumeration date
12/24/2009
Last updated
12/24/2009
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