NPIMap

Organization Active NPI

Kalkaska Memorial Health Center

Doing business as Kalkaska Memorial Health Center Pharmacy

  • Institutional Pharmacy
  • Kalkaska, MI
National Provider Identifier
1346647617
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
5301000299 Issued in MI
Legal business name
KALKASKA MEMORIAL HEALTH CENTER
Doing business as
Kalkaska Memorial Health Center Pharmacy
Practice address
419 S Coral St
Kalkaska, MI 49646-2503
Phone
(231) 258-7790
Fax
(231) 258-7756
NPI assigned
Dec 2, 2014
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew R. Raymond
Title
President/Ceo
Phone
(231) 258-3651

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301000299 MI
Institutional Pharmacy 3336I0012X 5301000299 MI Primary

Addresses

Primary practice location

419 S Coral St
Kalkaska, MI 49646-2503

Mailing address

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7790

Other identifiers 1

IdentifierTypeStateIssuer
1556877MedicaidMI

Other names 1

  • Kalkaska Memorial Health Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kalkaska Memorial Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1346647617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7790",
            "fax_number": "231-258-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7790",
            "fax_number": "231-258-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALKASKA MEMORIAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "231-258-3651"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301000299",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MI",
            "license": "5301000299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556877",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kalkaska Memorial Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalkaska, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.