Organization
MUNSON MEDICAL CENTER
Active
Organization
MUNSON MEDICAL CENTER
Active
Other names
Munson Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LARIA (VP, ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2349
(231) 935-5999
(231) 935-2167
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2349
(231) 935-5999
(231) 935-2167
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
5301000449
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160225
PK
—
01
—
470B80008
BLUE CROSS HIT
MI
05
—
5171477/87
—
MI
01
—
540B80537
BLUE CROSS - REGULAR
MI
Enumeration date
10/31/2006
Last updated
11/16/2023
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