Organization
MUNSON DIALYSIS CENTER
Active
Other names
Elizabeth C. Hosick Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LARAIA (VP ANCILLARY SERVICES)
(231) 935-5000
Entity
Organization
Contact information
Practice address
224 PARK AVE, FRANKFORT, MI 49635-9658
(231) 352-2922
(231) 352-2924
Mailing address
4062 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-5652
(231) 935-7792
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K8919
BCBS DIALYSIS
MI
01
—
K9420
BCBS SECONDARY DIALYSIS
MI
Enumeration date
11/22/2011
Last updated
10/03/2024
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