| Organization Name: | THREE RIVERS HEALTH SYSTEM, INC |
| NPI Number: | 1124390307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM RUSSELL (CEO/PRESIDENT) |
| Mailing Address: | 715 S Health Pkwy Three Rivers |
| State: | MI US |
| Postal Code: | 490938352 |
| Phone Number: | 2692738471 |
| Fax Number: | 2692739680 |
| NPI Enumeration Date: | 02/02/2012 |
| NPI Last Update Date: | 02/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 750020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |