1417441551 NPI number — HURLEY MEDICAL CENTER

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 1417441551 NPI number — HURLEY MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HURLEY MEDICAL CENTER
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:
6
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:
1417441551
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HURLEY PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48503-5902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-262-9255
Provider Business Mailing Address Fax Number:
810-262-7317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2065 S. CENTER RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-262-2360
Provider Business Practice Location Address Fax Number:
810-715-2998
Provider Enumeration Date:
06/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ECKER
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, PROFESSIONAL BILLING
Authorized Official Telephone Number:
810-262-9952

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)

  • Identifier: 386 . This is a "INSURANCE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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