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General NPI Number Information
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NPI Number | 1245769744
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH - MICHIGAN
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 475 S STATE ST
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City | SPARTA
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State | MI
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Zip | 49345-1549
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Country | US
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Telephone | 616-685-1300
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Fax | 616-887-5989
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Provider Business Mailing Address
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Address Line | 1900 44TH ST SE
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City | KENTWOOD
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State | MI
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Zip | 49508-5008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP, CNO
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Name | ELIZABETH MURPHY
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Credential |
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Telephone | 616-685-6411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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