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General NPI Number Information
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NPI Number | 1497820526
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Entity Type | Organization
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Legal Business Name | EMERGENCY CARE SPECIALISTS PC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4100 EMBASSY DR SE STE 201
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2416
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Country | US
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Telephone | 616-988-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 440 CRESCENT ST NE APT 5
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-3370
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Country | US
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Telephone | 269-998-5992
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RALPH ROGERS
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Credential | M.D.
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Telephone | 616-988-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 5601004845
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License Number State | MI
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