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General NPI Number Information
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NPI Number | 1346260692
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Entity Type | Organization
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Legal Business Name | MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 14700 LAKE SHORE DRIVE
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City | CHARLEVOIX
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State | MI
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Zip | 49720-1939
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Country | US
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Telephone | 231-547-4024
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Fax | 231-547-8088
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Provider Business Mailing Address
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Address Line | 14700 LAKE SHORE DRIVE
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City | CHARLEVOIX
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State | MI
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Zip | 49720-1939
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Country | US
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Telephone | 231-547-4024
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Fax | 231-547-8088
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Authorized Official
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Title or Position | PRESIDENT/CEO EAST REGION
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Name | KIRSTEN BETHANY KORTH-WHITE
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Credential |
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Telephone | 989-348-0720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 150021
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License Number State | MI
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