Healthcare Provider Details

I. General information

NPI: 1295926970
Provider Name (Legal Business Name): IRON COUNTY COMMUNITY HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W ICE LAKE RD
IRON RIVER MI
49935-9526
US

IV. Provider business mailing address

1400 W ICE LAKE RD
IRON RIVER MI
49935-9526
US

V. Phone/Fax

Practice location:
  • Phone: 906-265-6121
  • Fax:
Mailing address:
  • Phone: 906-265-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: GLENN E DOBSON
Title or Position: CFO
Credential:
Phone: 906-265-6121