Healthcare Provider Details

I. General information

NPI: 1275150120
Provider Name (Legal Business Name): CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1899
US

IV. Provider business mailing address

500 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1822
US

V. Phone/Fax

Practice location:
  • Phone: 906-635-4460
  • Fax: 906-635-7872
Mailing address:
  • Phone: 906-635-4460
  • Fax: 906-635-7872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN R KALCHIK
Title or Position: CFO
Credential:
Phone: 906-635-4456