Organization Name: | ASPIRUS KEWEENAW |
NPI Number: | 1750654661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHANE M JACQUES (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 300 Hecla St Laurium |
State: | MI US |
Postal Code: | 499132128 |
Phone Number: | 9063379355 |
Fax Number: | 9063374788 |
NPI Enumeration Date: | 02/23/2012 |
NPI Last Update Date: | 01/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |