Healthcare Provider Details
I. General information
NPI: 1073568978
Provider Name (Legal Business Name): MCLAREN CARO REGION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 N HOOPER ST
CARO MI
48723-1476
US
IV. Provider business mailing address
PO BOX 435
CARO MI
48723-0435
US
V. Phone/Fax
- Phone: 989-673-3141
- Fax: 989-673-8471
- Phone: 989-673-3141
- Fax: 989-673-8471
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 790032 |
| License Number State | MI |
VIII. Authorized Official
Name:
KENNETH
BARANSKI
Title or Position: CFO
Credential:
Phone: 989-269-1510