Provider Demographics
NPI:1659527737
Name:MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL
Other - Org Name:MEMORIAL MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JORRI
Authorized Official - Middle Name:
Authorized Official - Last Name:TREMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-729-4466
Mailing Address - Street 1:826 W KING ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2120
Mailing Address - Country:US
Mailing Address - Phone:989-723-5211
Mailing Address - Fax:989-723-9446
Practice Address - Street 1:826 W KING ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2120
Practice Address - Country:US
Practice Address - Phone:989-723-5211
Practice Address - Fax:989-723-9446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-08
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty