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General NPI Number Information
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NPI Number | 1508162561
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Entity Type | Organization
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Legal Business Name | DICKINSON COUNTY HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 2001 MINNEAPOLIS AVE SUITE D
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City | GLADSTONE
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State | MI
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Zip | 49837-2060
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Country | US
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Telephone | 906-776-5640
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Fax | 906-776-5639
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Provider Business Mailing Address
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Address Line | 2001 MINNEAPOLIS AVE SUITE D
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City | GLADSTONE
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State | MI
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Zip | 49837-2060
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Country | US
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Telephone | 906-776-5640
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Fax | 906-776-5639
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. JOHN SCHON
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Credential |
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Telephone | 906-774-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 220020
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License Number State | MI
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