Healthcare Provider Details

I. General information

NPI: 1285726828
Provider Name (Legal Business Name): MERCY HOSPITAL GRAYLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E MICHIGAN AVE
GRAYLING MI
49738-1312
US

IV. Provider business mailing address

PO BOX 160
CADILLAC MI
49601-0160
US

V. Phone/Fax

Practice location:
  • Phone: 231-876-7401
  • Fax: 231-876-7176
Mailing address:
  • Phone: 231-876-7401
  • Fax: 231-876-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateMI

VIII. Authorized Official

Name: STEPHANIE J. RIEMER-MATUZAK
Title or Position: CEO
Credential:
Phone: 989-348-0315