NPIMap

Organization Active NPI

Three Rivers Health System, Inc

Doing business as Three Rivers Health Family Care Centreville

  • Rural Health Clinic/Center
  • Centreville, MI
National Provider Identifier
1205108586
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
750020 Issued in MI
Legal business name
THREE RIVERS HEALTH SYSTEM, INC
Doing business as
Three Rivers Health Family Care Centreville
Practice address
677 E Main St Ste B
Centreville, MI 49032-8525
Phone
(269) 467-9011
Fax
(269) 467-9511
NPI assigned
Feb 2, 2012
Last updated
Feb 2, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
THREE RIVERS HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Russell
Title
Ceo/President
Phone
(269) 273-9601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 750020 MI Primary

Addresses

Primary practice location

677 E Main St Ste B
Centreville, MI 49032-8525

Mailing address

677 E Main St Ste B
P.O. Box 310
Centreville, MI 49032-8525
Phone (269) 467-9011

Other names 1

  • Three Rivers Health Family Care Centreville Doing business as

National Provider Directory

National Provider Directory
Part of
Three Rivers Health System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1205108586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST STE B",
            "address_2": "P.O. BOX 310",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328525",
            "telephone_number": "269-467-9011",
            "fax_number": "269-467-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST STE B",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328525",
            "telephone_number": "269-467-9011",
            "fax_number": "269-467-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THREE RIVERS HEALTH",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "269-273-9601"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "750020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Health Family Care Centreville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centreville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.