# MERCY HOSPITAL GRAYLING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MHSN Primary Care Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346481553
- **Authorized official:** STEPHANIE RIEMER (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (989) 348-5461

## Contact information

- **Practice address:** 2585 W HOUGHTON LAKE DR, PRUDENVILLE, MI 48651-9624
- **Practice address phone:** (989) 366-2900
- **Mailing address:** PO BOX 566, GRAYLING, MI 49738-0566
- **Mailing address phone:** (989) 348-1040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/18/2009
- **Last updated:** 02/09/2015