Geriatric & Extended Rehabilitation Medicine LLC
Family Medicine, Geriatric Medicine in Grand Haven, MI. Organization (NPI-2).
NPI number1609810985
StatusActive
Last updated in NPPESOct 4, 2011
Details
- NPI
- 1609810985
- Entity type
- Organization (NPI-2)
- Legal business name
- Geriatric & Extended Rehabilitation Medicine LLC
- Organization subpart
- No
- Enumeration date
- Jun 16, 2006
- Last updated
- Oct 4, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QG0300X | Family Medicine, Geriatric Medicine | 5101009705 | MI | Yes |
Practice location
1159 S Harbor DrSuite C-4
Grand Haven, MI 49417-1777
Phone 616-844-4067 · Fax 616-844-4067
Mailing address
1159 S HarborC4
Grand Haven, MI 49417-1777
Phone 616-844-4067 · Fax 616-844-4067
Authorized official
Donald Ezra Rutherford
Owner President
6168444067
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.