Organization
THREE RIVERS HEALTH AUTHORITY
Active
Other names
Three Rivers Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RUSSELL (CEO)
(269) 273-9601
Entity
Organization
Contact information
Practice address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 273-9789
(269) 273-9611
Mailing address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 278-1145
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
750020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N99470
MEDICARE - DIETICIAN GROUP
MI
05
—
1556456-30
—
MI
05
—
5172151-40
—
MI
Enumeration date
11/17/2005
Last updated
07/05/2011
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