Healthcare Provider Details

I. General information

NPI: 1932628922
Provider Name (Legal Business Name): MUNISING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E21843 GRAND MARAIS AVE
GRAND MARAIS MI
49839-4986
US

IV. Provider business mailing address

1500 SANDPOINT RD
MUNISING MI
49862-1406
US

V. Phone/Fax

Practice location:
  • Phone: 906-387-4338
  • Fax: 906-387-2825
Mailing address:
  • Phone: 906-387-4338
  • Fax: 906-387-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ANN PARKKILA
Title or Position: CONTROLLER
Credential:
Phone: 906-387-0613