MEDICARE: MACKINAC STRAITS HEALTH SYSTEM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1245554914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACKINAC STRAITS HEALTH SYSTEM INC

Provider Business Mailing Address
First Line	:	1140 N STATE ST
Second Line	:
City	:	SAINT IGNACE
State	:	MI
Zip	:	49781-1048
Country	:	US
Telephone Number	:	906-643-8585
Fax Number	:	906-643-0373

Provider Business Practice Location Address
First Line	:	14540 N MACKINAW HIGHWAY
Second Line	:
City	:	MACKINAW CITY
State	:	MI
Zip	:	49701-9507
Country	:	US
Telephone Number	:	231-436-9900
Fax Number	:	231-436-5357

Authorized Official
Title or Position	:	CFO
Name	:	MR. JASON C ANDERSON
Credential	:
Telephone Number	:	906-643-0435

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	11/12/2024

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