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Organization
COMMUNITY MEMORIAL HOSPITAL
Active
Organization
COMMUNITY MEMORIAL HOSPITAL
Active
Other names
Cheboygan Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TED P ANDERSON (VICE PRESIDENT/FINANCE)
(231) 627-1203
Entity
Organization
Contact information
Practice address
748 S MAIN ST, CHEBOYGAN, MI 49721-2220
(231) 627-1242
(231) 627-1452
Mailing address
PO BOX 419, CHEBOYGAN, MI 49721-0419
(231) 627-1242
(231) 627-1452
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
163010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09718
BLUE CROSS BLUE SHIELD
MI
01
—
15141
BLUE CROSS BLUE SHIELD
MI
05
—
2000260
—
MI
Enumeration date
06/28/2006
Last updated
05/29/2008
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