Provider Demographics
NPI:1245554914
Name:MACKINAC STRAITS HEALTH SYSTEM INC
Entity type:Organization
Organization Name:MACKINAC STRAITS HEALTH SYSTEM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-643-0435
Mailing Address - Street 1:1140 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781-1048
Mailing Address - Country:US
Mailing Address - Phone:906-643-8585
Mailing Address - Fax:906-643-0373
Practice Address - Street 1:14540 N MACKINAW HIGHWAY
Practice Address - Street 2:
Practice Address - City:MACKINAW CITY
Practice Address - State:MI
Practice Address - Zip Code:49701-9507
Practice Address - Country:US
Practice Address - Phone:231-436-9900
Practice Address - Fax:231-436-5357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MACKINAC STRAITS HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-24
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
238651Medicare Oscar/Certification