Healthcare Provider Details

I. General information

NPI: 1831341809
Provider Name (Legal Business Name): HURLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 RIVER FOREST DR APTT #1139
FLINT MI
48532-2807
US

IV. Provider business mailing address

1131 RIVER FOREST DR APTT #1139
FLINT MI
48532-2807
US

V. Phone/Fax

Practice location:
  • Phone: 734-277-2797
  • Fax:
Mailing address:
  • Phone: 734-277-2797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number4301093346
License Number StateMI

VIII. Authorized Official

Name: MRS. ANNITA LINN
Title or Position: COORDINATOR
Credential:
Phone: 810-762-6426