NPIMap

Organization Active NPI

Munson Healthcare Charlevoix Hospital

  • Community/Retail Pharmacy
  • Charlevoix, MI
National Provider Identifier
1467498378
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301002539 Issued in MI
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone
(231) 547-8589
Fax
(231) 547-0325
NPI assigned
Jun 20, 2006
Last updated
Dec 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Authorized official

Name
Kathleen Laraia, RPH
Title
VP, Ancillary Services
Phone
(231) 392-8410

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5301002539 MI Primary

Addresses

Primary practice location

14700 Lake Shore Dr
Charlevoix, MI 49720-1931

Mailing address

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-8589

Other identifiers 1

IdentifierTypeStateIssuer
2323400OtherNCPDP PROVIDER IDENTIFICATION NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Charlevoix Area Hosptia13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1467498378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-8589",
            "fax_number": "231-547-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-8589",
            "fax_number": "231-547-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "LARAIA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP, ANCILLARY SERVICES",
        "authorized_official_telephone_number": "231-392-8410",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301002539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2323400",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.