# MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEMORIAL HOSPITAL
- **Other names:** Memorial Medical Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316008006
- **Legal business name:** MEMORIAL HOSPITAL
- **Authorized official:** JORRI M TREMAIN (CFO)
- **Authorized official phone:** (989) 729-4466

## Contact information

- **Practice address:** 826 W KING ST, OWOSSO, MI 48867-2120
- **Practice address phone:** (989) 723-5211
- **Practice address fax:** (989) 723-9446
- **Mailing address:** 113 E WILLIAMS ST, OWOSSO, MI 48867-2360
- **Mailing address phone:** (989) 725-6528
- **Mailing address fax:** (989) 723-9446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 1060000059 | MI | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | 1060000059 | MI | — |
| 207X00000X | Orthopaedic Surgery Physician | 1060000059 | MI | — |
| 207YS0123X | Facial Plastic Surgery Physician | 1060000059 | MI | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |
| 2084N0400X | Neurology Physician | 1060000059 | MI | — |
| 208600000X | Surgery Physician | 106000059 | MI | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 09/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080G810270 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 1316008006 | — | MI |