Healthcare Provider Details

I. General information

NPI: 1083659502
Provider Name (Legal Business Name): DICKINSON COUNTY HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 S STEPHENSON AVE STE 210
IRON MOUNTAIN MI
49801-3649
US

IV. Provider business mailing address

1000 N OAK AVE ATTN: PROVIDER ENROLLMENT COORDINATOR SHP FL 2
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 906-776-5800
  • Fax: 906-776-5801
Mailing address:
  • Phone: 715-389-0660
  • 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: JOLYN MUNSON
Title or Position: VP REVENUE CYCLE OPERATIONS
Credential:
Phone: 605-328-6585