1932628922 NPI number — MUNISING MEMORIAL HOSPITAL ASSOCIATION

Table of content: (NPI 1932628922)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932628922 NPI number — MUNISING MEMORIAL HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUNISING MEMORIAL HOSPITAL ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAY CARE MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932628922
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 SAND POINT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNISING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
906-387-4338
Provider Business Mailing Address Fax Number:
906-387-2825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
E21843 GRAND MARAIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND MARAIS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49839-4986
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-387-4338
Provider Business Practice Location Address Fax Number:
906-387-2825
Provider Enumeration Date:
09/12/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HOLSWORTH
Authorized Official First Name:
HANNAH
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHYSICIAN SERVICES
Authorized Official Telephone Number:
906-387-4110

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com