Provider Demographics
NPI:1053683235
Name:THREE RIVERS HEALTH SYSTEM, INC
Entity Type:Organization
Organization Name:THREE RIVERS HEALTH SYSTEM, INC
Other - Org Name:ANDRZEJ AND ANNA CHEBES, MD - INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-273-9601
Mailing Address - Street 1:1021 HILL ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-2745
Mailing Address - Country:US
Mailing Address - Phone:269-858-3024
Mailing Address - Fax:269-273-9040
Practice Address - Street 1:1021 HILL ST
Practice Address - Street 2:SUITE 300
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2745
Practice Address - Country:US
Practice Address - Phone:269-858-3024
Practice Address - Fax:269-273-9040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE RIVERS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-02
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI750020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty