Provider Demographics
NPI:1437230935
Name:THE GRAND RIVER HEALTH SYSTEM CORPORATION
Entity Type:Organization
Organization Name:THE GRAND RIVER HEALTH SYSTEM CORPORATION
Other - Org Name:HEDRICK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-646-2682
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:HALE
Mailing Address - State:MO
Mailing Address - Zip Code:64643-0086
Mailing Address - Country:US
Mailing Address - Phone:660-565-2602
Mailing Address - Fax:660-565-2604
Practice Address - Street 1:321 ELM STREET
Practice Address - Street 2:
Practice Address - City:HALE
Practice Address - State:MO
Practice Address - Zip Code:64643
Practice Address - Country:US
Practice Address - Phone:660-565-2602
Practice Address - Fax:660-565-2604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GRAND RIVER HEALTH SYSTEM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health