# MUNSON MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689897779
- **Authorized official:** KATHLEEN LARAIA (VP, ANCILLARY SERVICES)
- **Authorized official phone:** (231) 392-8410

## Contact information

- **Practice address:** 1105 6TH ST, TRAVERSE CITY, MI 49684-2345
- **Practice address phone:** (231) 935-6584
- **Practice address fax:** (231) 935-5667
- **Mailing address:** 1105 6TH ST, TRAVERSE CITY, MI 49684-2345
- **Mailing address phone:** (231) 935-6584
- **Mailing address fax:** (231) 935-5667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 5301000449 | MI | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | 5301000449 | MI | — |
| 3336I0012X | Institutional Pharmacy | 5301000449 | MI | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 12/29/2023