1467967950 NPI number — HOPE PRIMARY AND URGENT CARE OF REED CITY PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467967950 NPI number — HOPE PRIMARY AND URGENT CARE OF REED CITY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE PRIMARY AND URGENT CARE OF REED CITY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467967950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9171 LAPEER ROAD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
DAVISON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48423-3617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-412-5590
Provider Business Mailing Address Fax Number:
810-412-5593

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4361 200TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REED CITY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-832-3930
Provider Business Practice Location Address Fax Number:
231-832-2456
Provider Enumeration Date:
12/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HORNE
Authorized Official First Name:
PATTY
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
810-412-5590

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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