# MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Munson Healthcare OMH Medical Group-Elmira RHC, OMH Medical Group - Boyne Valley RHC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992146807
- **Authorized official:** ALICIA MAITLAND (CFO)
- **Authorized official phone:** (231) 935-7840

## Contact information

- **Practice address:** 2572 N US HIGHWAY 131, ELMIRA, MI 49730
- **Practice address phone:** (989) 731-7708
- **Mailing address:** 829 N CENTER AVE, GAYLORD, MI 49735-1595
- **Mailing address phone:** (989) 731-7777
- **Mailing address fax:** (989) 731-7776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | MI | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 282NR1301X | Rural Acute Care Hospital | — | MI | — |

## Other

- **Enumeration date:** 07/09/2013
- **Last updated:** 09/22/2021