MUNSON HEALTHCARE GRAYLING NPI 1144626052

NPI Information

NPI: 1144626052
Provider Name: MUNSON HEALTHCARE GRAYLING
Classification: Clinic/Center - 261QR1300X
Specialization: Rural Health
Entity Type: Organization
Doing Business As: PRUDENVILLE COMMUNITY HEALTH CENTER
Address: 2585 W HOUGHTON LAKE DR
PRUDENVILLE, MI
ZIP 48651
Phone: (989) 366-2900

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NPI Details

MUNSON HEALTHCARE GRAYLING is a rural health clinic center in Prudenville, MI. MUNSON HEALTHCARE GRAYLING NPI is 1144626052. The provider is registered as an organization entity type.
The provider Is Doing Business As Prudenville Community Health Center.

The provider's business location address is:

2585 W HOUGHTON LAKE DR
PRUDENVILLE, MI
ZIP 48651-624
Phone: (989) 366-2900

The provider's authorized official is Bonnie Kruszka .
The authorized official title is Coo Munson Physician Network and has the following contact phone number (231) 935-4995.

The enumeration date for this NPI number is 11/5/2014 and was last updated on 10/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00030	OTHER	MICHIGAN	BLUE CROSS
2	238562	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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