Healthcare Provider Details

I. General information

NPI: 1689759425
Provider Name (Legal Business Name): MERCY HOSPITAL GRAYLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
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

1100 E MICHIGAN AVE
GRAYLING MI
49738-1312
US

V. Phone/Fax

Practice location:
  • Phone: 989-348-0337
  • Fax: 989-348-0529
Mailing address:
  • Phone: 989-348-0337
  • Fax: 989-348-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: CHARLOTTE SMITH
Title or Position: DIRECTOR, MERCY MANOR
Credential:
Phone: 989-348-0337