Provider Demographics
NPI:1376853291
Name:SOUTH HURON URGENT CARE CENTER PLC
Entity Type:Organization
Organization Name:SOUTH HURON URGENT CARE CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEKAI-VEKIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-480-0990
Mailing Address - Street 1:1649 S HURON ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9701
Mailing Address - Country:US
Mailing Address - Phone:734-480-0990
Mailing Address - Fax:734-480-0955
Practice Address - Street 1:1649 S HURON ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9701
Practice Address - Country:US
Practice Address - Phone:734-480-0990
Practice Address - Fax:734-480-0955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070863261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1376853291OtherNPI
1376853291OtherNPI