Provider Demographics
NPI:1194069419
Name:DICKINSON COUNTY HEALTHCARE SYSTEM
Entity type:Organization
Organization Name:DICKINSON COUNTY HEALTHCARE SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ADMINISTRATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-776-5640
Mailing Address - Street 1:440 WOODWARD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-4631
Mailing Address - Country:US
Mailing Address - Phone:906-828-1832
Mailing Address - Fax:906-779-1478
Practice Address - Street 1:440 WOODWARD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-4631
Practice Address - Country:US
Practice Address - Phone:906-828-1832
Practice Address - Fax:906-779-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory