Basic Information
| Provider Information | |||||||||
| NPI: | 1467652784 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | ||||||||
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| OtherOrganizationName: | ASPIRUS DIALYSIS - CRYSTAL FALLS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 W ICE LAKE RD | ||||||||
| Address2: | |||||||||
| City: | IRON RIVER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 499359526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062656121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1328 US HIGHWAY 2 | ||||||||
| Address2: | |||||||||
| City: | CRYSTAL FALLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 499201045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9068754746 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2007 | ||||||||
| LastUpdateDate: | 09/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | DOBSON | ||||||||
| AuthorizedOfficialFirstName: | GLENN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9062650436 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |
No ID Information.