MEDICARE: ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1639427693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC.

Provider Business Mailing Address
First Line	:	1400 W ICE LAKE RD
Second Line	:
City	:	IRON RIVER
State	:	MI
Zip	:	49935-9526
Country	:	US
Telephone Number	:	906-265-6121
Fax Number	:	906-265-4245

Provider Business Practice Location Address
First Line	:	927 RIVERSIDE PLZ
Second Line	:
City	:	IRON RIVER
State	:	MI
Zip	:	49935-1529
Country	:	US
Telephone Number	:	906-265-2165
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	GLENN DOBSON
Credential	:
Telephone Number	:	906-265-0436

Provider Enumeration Date	:	08/23/2012
Last Update Date	:	09/16/2015

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