# MUNSON HEALTHCARE GRAYLING HOSPITAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Munson Healthcare Grayling Hospital Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417047382
- **Authorized official:** KATHLEEN LARAIA (VP, ANCILLARY SERVICES)
- **Authorized official phone:** (231) 392-8410

## Contact information

- **Practice address:** 1100 E MICHIGAN AVE, GRAYLING, MI 49738-1312
- **Practice address phone:** (989) 348-0800
- **Practice address fax:** (989) 348-0462
- **Mailing address:** 1100 E MICHIGAN AVE, GRAYLING, MI 49738-1312
- **Mailing address phone:** (989) 348-0800
- **Mailing address fax:** (989) 348-0462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | 5301010626 | MI | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 12/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2151931 | PK | — |