1730649575 NPI number — HURLEY MEDICAL CENTER

Table of content: (NPI 1730649575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730649575 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:
1730649575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2019
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:
810-262-9353
Provider Business Mailing Address Fax Number:
810-262-9483

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5494 S DORT HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48507-4483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-262-7731
Provider Business Practice Location Address Fax Number:
810-695-2032
Provider Enumeration Date:
03/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
SCHANG
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
A
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 . This identifiers is of the category "OTHER".




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