Healthcare Provider Details

I. General information

NPI: 1497751309
Provider Name (Legal Business Name): KALKASKA MEMORIAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 S CORAL ST
KALKASKA MI
49646
US

IV. Provider business mailing address

PO BOX 916
TRAVERSE CITY MI
49685-0916
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6181
  • Fax:
Mailing address:
  • Phone: 231-935-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateMI

VIII. Authorized Official

Name: ANDREW R. RAYMOND
Title or Position: PRESIDENT/CEO
Credential:
Phone: 231-258-3651