Healthcare Provider Details

I. General information

NPI: 1841104718
Provider Name (Legal Business Name): MUNSON HEALTHCARE CADILLAC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 OAK ST STE B
CADILLAC MI
49601-2312
US

IV. Provider business mailing address

711 OAK ST STE B
CADILLAC MI
49601-2312
US

V. Phone/Fax

Practice location:
  • Phone: 231-244-2507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATHLEEN LARAIA
Title or Position: VP ONCOLOGY AND PROF. SERVICES
Credential:
Phone: 231-310-8410