Healthcare Provider Details

I. General information

NPI: 1801934930
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER ALPENA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S BRADLEY HWY SUITE 6
ROGERS CITY MI
49779-2139
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-0001
US

V. Phone/Fax

Practice location:
  • Phone: 989-734-4254
  • Fax: 989-734-8914
Mailing address:
  • Phone: 989-734-4254
  • Fax: 989-734-8914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberL905569
License Number StateMI

VIII. Authorized Official

Name: MS. JULIE ANN SCOTT
Title or Position: CERTIFIED OCCUPATIONAL THERAPY ASST
Credential: COTA
Phone: 989-734-4254