Healthcare Provider Details

I. General information

NPI: 1578073318
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER SAULT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33896 S TOWNLINE RD
DRUMMOND ISLAND MI
49726
US

IV. Provider business mailing address

500 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1822
US

V. Phone/Fax

Practice location:
  • Phone: 906-493-5221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA M PEIRCE
Title or Position: MANAGER PATIENT ACCOUNTS
Credential:
Phone: 989-356-7597