Basic Information
| Provider Information | |||||||||
| NPI: | 1770758724 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IRON COUNTY COMMUNITY HOSPITALS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 WEST ICE LAKE ROAD | ||||||||
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| City: | IRON RIVER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062656121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 WEST ICE LAKE ROAD | ||||||||
| Address2: | |||||||||
| City: | IRON RIVER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062656121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2008 | ||||||||
| LastUpdateDate: | 04/29/2008 | ||||||||
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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 | 207L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207P00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207ZP0105X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | 2085R0202X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.