Healthcare Provider Details

I. General information

NPI: 1427611391
Provider Name (Legal Business Name): MUNISING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 03/22/2024
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SANDPOINT RD
MUNISING MI
49862-1406
US

IV. Provider business mailing address

1500 SANDPOINT RD
MUNISING MI
49862-1406
US

V. Phone/Fax

Practice location:
  • Phone: 906-387-4338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES PARKER
Title or Position: CEO
Credential:
Phone: 906-387-4110