Organization
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL
Active
Other names
OTSEGO MEMORIAL HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LARAIA (VP, ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
825 N CENTER AVE, GAYLORD, MI 49735
(989) 731-2163
(989) 731-2162
Mailing address
825 N CENTER AVE, GAYLORD, MI 49735-1592
(989) 731-2163
(989) 731-2162
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
5301002513
MI
3336I0012X
Institutional Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2041951
PK
—
05
—
5171589
—
MI
Enumeration date
12/14/2006
Last updated
07/17/2024
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