Organization
MUNSON MEDICAL CENTER
Active
Parent organization
MUNSON MEDICAL CENTER
Other names
Munson Healthcare Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MUNSON MEDICAL CENTER
Authorized official
KATHLEEN LARAIA (VP, ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
FOSTER FAMILY COMMUNITY HEALTH CENTER, 550 MUNSON AVE UNIT 4, TRAVERSE CITY, MI 49686
(231) 935-8736
(231) 213-8716
Mailing address
FOSTER FAMILY COMMUNITY HEALTH CENTER, 550 MUNSON AVE UNIT 4, TRAVERSE CITY, MI 49686
(231) 935-8736
(231) 213-8716
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5171477
—
MI
Enumeration date
03/06/2023
Last updated
12/29/2023
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