Organization
THREE RIVERS HEALTH AUTHORITY
Active
Parent organization
THREE RIVERS HEALTH
Other names
Three Rivers Health Family Care Centreville
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
677 E MAIN ST STE B, CENTREVILLE, MI 49032-8525
(269) 467-9011
(269) 467-9511
Mailing address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 273-9789
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
750020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700G560080
BCBSM
MI
Enumeration date
12/02/2005
Last updated
04/04/2013
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