Organization
MUNSON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LARAIA (VP, ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6584
(231) 935-5667
Mailing address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6584
(231) 935-5667
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
5301000449
MI
3336H0001X
Home Infusion Therapy Pharmacy
5301000449
MI
3336I0012X
Institutional Pharmacy
Primary
5301000449
MI
Other
Enumeration date
04/10/2007
Last updated
12/29/2023
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