Organization
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LARAIA RPH (VP, ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
14700 LAKE SHORE DR, CHARLEVOIX, MI 49720-1931
(231) 547-8589
(231) 547-0325
Mailing address
14700 LAKE SHORE DR, CHARLEVOIX, MI 49720-1931
(231) 547-8589
(231) 547-0325
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301002539
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2323400
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/20/2006
Last updated
12/29/2023
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