# COMMUNITY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cheboygan Memorial Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598793945
- **Authorized official:** MR. TED P ANDERSON (VICE PRESIDENT/FINANCE)
- **Authorized official phone:** (231) 627-1203

## Contact information

- **Practice address:** 748 S MAIN ST, CHEBOYGAN, MI 49721-2220
- **Practice address phone:** (231) 627-1242
- **Practice address fax:** (231) 627-1452
- **Mailing address:** PO BOX 419, CHEBOYGAN, MI 49721-0419
- **Mailing address phone:** (231) 627-1242
- **Mailing address fax:** (231) 627-1452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 163010 | MI | Yes |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 05/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09718 | BLUE CROSS BLUE SHIELD | MI |
| 01 | — | 15141 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 2000260 | — | MI |