Provider Demographics
NPI: | 1730649575 |
---|---|
Name: | HURLEY MEDICAL CENTER |
Entity type: | Organization |
Organization Name: | HURLEY MEDICAL CENTER |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR, PROFESSIONAL BILLING |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RUTH |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | SCHANG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 810-262-9952 |
Mailing Address - Street 1: | 1 HURLEY PLZ |
Mailing Address - Street 2: | |
Mailing Address - City: | FLINT |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48503-5902 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 810-262-9353 |
Mailing Address - Fax: | 810-262-9483 |
Practice Address - Street 1: | 5494 S DORT HWY |
Practice Address - Street 2: | |
Practice Address - City: | FLINT |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48507-4483 |
Practice Address - Country: | US |
Practice Address - Phone: | 810-262-7731 |
Practice Address - Fax: | 810-695-2032 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-03-20 |
Last Update Date: | 2019-04-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
386 | Other | INSURANCE |