# MCLAREN NORTHERN MICHIGAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern Michigan Regional Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083771364
- **Authorized official:** MR. KEVIN PENDLETON RPH (PHARMACY MANAGER)
- **Authorized official phone:** (231) 487-4843

## Contact information

- **Practice address:** 416 CONNABLE AVE, PETOSKEY, MI 49770-2212
- **Practice address phone:** (231) 487-4843
- **Practice address fax:** (231) 487-4817
- **Mailing address:** 416 CONNABLE AVE, PETOSKEY, MI 49770-2212
- **Mailing address phone:** (231) 487-4843
- **Mailing address fax:** (231) 487-4817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 5301002202 | MI | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 12/19/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2324349 | NCPDP NUMBER | — |
| 05 | — | 5171539 | — | MI |