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General NPI Number Information
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NPI Number | 1134101983
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Entity Type | Organization
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Legal Business Name | MYMICHIGAN MEDICAL CENTER MIDLAND
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 2597 S. MERIDIAN ROAD
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City | MT. PLEASANT
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State | MI
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Zip | 48858-9057
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Country | US
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Telephone | 989-773-6137
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Fax | 989-773-1072
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Provider Business Mailing Address
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Address Line | 6810 EASTMAN AVE
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City | MIDLAND
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State | MI
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Zip | 48642-7805
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Country | US
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Telephone |
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Fax | 989-633-0735
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES HARRY SHERWIN
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Credential |
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Telephone | 989-356-7779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 374021
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 373510
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License Number State | MI
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