THREE RIVERS HEALTH AUTHORITY NPI 1508840596

NPI Information

NPI: 1508840596
Provider Name: THREE RIVERS HEALTH AUTHORITY

Doing Business As: THREE RIVERS HEALTH FAMILY CARE CENTREVILLE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
677 E MAIN ST STE B
CENTREVILLE, MI
ZIP 49032
Phone: (269) 467-9011
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THREE RIVERS HEALTH AUTHORITY is a rural health clinic center in Centreville, MI. THREE RIVERS HEALTH AUTHORITY NPI is 1508840596. The provider is registered as an organization entity type.
The provider Is Doing Business As Three Rivers Health Family Care Centreville.

The provider's business location address is:

677 E MAIN ST STE B
CENTREVILLE, MI
ZIP 49032-525
Phone: (269) 467-9011
Fax: (269) 467-9511

The provider's authorized official is William Russell .
The authorized official title is Ceo/president and has the following contact phone number (269) 273-9601.

The CLIA number assigned to this NPI record is 23D1041799 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2005 and was last updated on 4/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	750020	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	700G560080	OTHER	MICHIGAN	BCBSM
2	238511	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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