MEDICARE: HEALTHSOURCE SAGINAW INC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
2	273R00000X	Psychiatric Hospital Unit	H026/2001(2)	MI
3	273Y00000X	Rehabilitation Hospital Unit	730060	MI
4	276400000X	Substance Use Disorder Rehabilitation Hospital Unit	730034	MI
5	313M00000X	Nursing Facility/Intermediate Care Facility	733010	MI
6	314000000X	Skilled Nursing Facility	733010	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CD4197	OTHER	MI	PALMETTO GBA RAILROAD MEDICARE
2	CE4327	OTHER	MI	PALMETTO GBA RAILROAD MEDICARE
4	CE4324	OTHER	MI	PALMETTO GBA RAILROAD MEDICARE
8	CE4328	OTHER	MI	PALMETTO GBA RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	00237	OTHER	MI	BCBS HOSPITAL UNITS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1265426704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSOURCE SAGINAW INC

Provider Business Mailing Address
First Line	:	3340 HOSPITAL RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-9622
Country	:	US
Telephone Number	:	989-790-7700
Fax Number	:	989-790-7297

Provider Business Practice Location Address
First Line	:	3340 HOSPITAL RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-9622
Country	:	US
Telephone Number	:	989-790-7700
Fax Number	:	989-790-9297

Authorized Official
Title or Position	:	DIRECTOR PATIENT ACCOUNTING
Name	:	MARY E WILLIAMS
Credential	:
Telephone Number	:	989-790-7783

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	01/19/2024

3353 HOSPITAL RD
SAGINAW, MI
48603-9622

Practice Phone: 616-301-8000
Practice Fax: