Healthcare Provider Details

I. General information

NPI: 1801299953
Provider Name (Legal Business Name): ASPIRUS NORTHSTAR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 W GENESEE ST
IRON RIVER MI
49935-1438
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 906-265-5423
  • Fax: 906-265-0491
Mailing address:
  • Phone: 906-265-6121
  • Fax: 906-265-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GLENN DOBSON
Title or Position: CFO
Credential:
Phone: 906-265-0436