Healthcare Provider Details

I. General information

NPI: 1417862806
Provider Name (Legal Business Name): TRI-COUNTY RURAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W OAK ST NE
SAND LAKE MI
49343
US

IV. Provider business mailing address

PO BOX 319
SAND LAKE MI
49343-0319
US

V. Phone/Fax

Practice location:
  • Phone: 616-439-0222
  • Fax:
Mailing address:
  • Phone: 616-439-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JEROD GARDNER
Title or Position: PHYSICIAN OWNER
Credential: DO
Phone: 517-927-8609