Healthcare Provider Details
I. General information
NPI: 1740504943
Provider Name (Legal Business Name): DICKINSON COUNTY HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2010
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
N1667 US HIGHWAY 8
NORWAY MI
49870-2003
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
- Phone: 906-563-7323
- Fax: 906-563-7120
- Phone: 715-389-0660
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | 220020 |
| License Number State | MI |
VIII. Authorized Official
Name:
JOLYN
MUNSON
Title or Position: VP REVENUE CYCLE OPERATIONS
Credential:
Phone: 605-328-6585