Organization
MARY FREE BED HOSPITAL AND REHABILITATION
Active
Other names
Mary Free Bed Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL DENEFF (VP CHIEF FINANCIAL OFFICER)
(616) 242-0403
Entity
Organization
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0403
(616) 242-9113
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 242-0403
(616) 242-9113
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D16364
BLUE CROSS PHYSICIAN GROUP BILLING
MI
Enumeration date
05/02/2008
Last updated
05/02/2008
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