NPIMap

Organization Active NPI

Munson Medical Center

  • Institutional Pharmacy
  • Traverse City, MI
National Provider Identifier
1689897779
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
5301000449 Issued in MI
Legal business name
MUNSON MEDICAL CENTER
Practice address
1105 6TH St
Traverse City, MI 49684-2345
Phone
(231) 935-6584
Fax
(231) 935-5667
NPI assigned
Apr 10, 2007
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
Title
VP, Ancillary Services
Phone
(231) 392-8410

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301000449 MI
Home Infusion Therapy Pharmacy 3336H0001X 5301000449 MI
Institutional Pharmacy 3336I0012X 5301000449 MI Primary

Addresses

Primary practice location

1105 6TH St
Traverse City, MI 49684-2345

Mailing address

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-6584

National Provider Directory

National Provider Directory
Tax ID family
Leroy Futterer MD28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1689897779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-6584",
            "fax_number": "231-935-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-6584",
            "fax_number": "231-935-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "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"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301000449",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "MI",
            "license": "5301000449",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MI",
            "license": "5301000449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, 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.