Healthcare Provider Details

I. General information

NPI: 1376040659
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER MIDLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-794-2950
  • Fax: 989-794-2962
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SARAH JAMES
Title or Position: MANAGER, PROVIDER ENROLLMENT
Credential:
Phone: 989-701-4734