Healthcare Provider Details

I. General information

NPI: 1285072736
Provider Name (Legal Business Name): ADRIAN DOMINICAN SISTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 E SIENA HEIGHTS DR
ADRIAN MI
49221-1755
US

IV. Provider business mailing address

PO BOX 489
ADRIAN MI
49221-0489
US

V. Phone/Fax

Practice location:
  • Phone: 517-266-3400
  • Fax: 517-266-3569
Mailing address:
  • Phone: 517-266-3400
  • Fax: 517-266-3569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CORRINE SANDERS
Title or Position: ADMINISTRATOR TREASURER
Credential:
Phone: 517-266-3512