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Contact Information

GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC
1159 S HARBOR DR
SUITE C-4
GRAND HAVEN, MI49417-1777
 Phone: 616-844-4067
 Fax: 616-844-4067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC

NPI Number 1609810985
LBN Legal business name GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC
Authorized official DONALD RUTHERFORD - (OWNER PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/16/2006
Last updated 10/04/2011 - About 15 years ago
Identifiers
MI License # 5101009705
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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