Healthcare Provider Details

I. General information

NPI: 1861400400
Provider Name (Legal Business Name): HURON COUNTY BUILDING OFFICE OF TREASURER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 S VAN DYKE RD
BAD AXE MI
48413-9615
US

IV. Provider business mailing address

1116 S VAN DYKE RD
BAD AXE MI
48413-9615
US

V. Phone/Fax

Practice location:
  • Phone: 989-269-6425
  • Fax: 989-269-7352
Mailing address:
  • Phone: 989-269-6425
  • Fax: 989-269-7352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number328510
License Number StateMI

VIII. Authorized Official

Name: MR. KEITH M MILLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 989-269-6425