Basic Information
Provider Information
NPI: 1538195409
EntityType: 2
ReplacementNPI:  
OrganizationName: MCLAREN CENTRAL MICHIGAN
LastName:  
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Mailing Information
Address1: 1221 SOUTH DR
Address2:  
City: MT PLEASANT
State: MI
PostalCode: 488583234
CountryCode: US
TelephoneNumber: 9897726700
FaxNumber: 9897726807
Practice Location
Address1: 1221 SOUTH DR
Address2:  
City: MT PLEASANT
State: MI
PostalCode: 488583234
CountryCode: US
TelephoneNumber: 9897726700
FaxNumber: 9897726807
Other Information
ProviderEnumerationDate: 06/23/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SOULES
AuthorizedOfficialFirstName: TARA
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AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 9897726720
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X MIY HospitalsGeneral Acute Care Hospital 

No ID Information.


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