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General NPI Number Information
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NPI Number | 1326135179
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH MERCY PORT HURTON
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 2601 ELECTRIC AVE
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City | PORT HURON
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State | MI
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Zip | 48060-6587
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Country | US
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Telephone | 810-985-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 ELECTRIC AVE
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City | PORT HURON
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State | MI
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Zip | 48060-6587
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Country | US
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Telephone | 810-985-1500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | REBEKAH SMITH
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Credential |
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Telephone | 810-985-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 740010
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License Number State | MI
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