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General NPI Number Information
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NPI Number | 1346647617
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Entity Type | Organization
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Legal Business Name | KALKASKA MEMORIAL HEALTH CENTER
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 419 S CORAL ST
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City | KALKASKA
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State | MI
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Zip | 49646-2503
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Country | US
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Telephone | 231-258-7790
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Fax | 231-258-7756
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Provider Business Mailing Address
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Address Line | 419 S CORAL ST
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City | KALKASKA
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State | MI
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Zip | 49646-2503
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Country | US
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Telephone | 231-258-7790
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Fax | 231-258-7756
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ANDREW R. RAYMOND
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Credential |
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Telephone | 231-258-3651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301000299
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 5301000299
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License Number State | MI
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