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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