Provider Demographics
NPI:1609970359
Name:HOSPITAL HEALTH CARE INC.
Entity Type:Organization
Organization Name:HOSPITAL HEALTH CARE INC.
Other - Org Name:CLARKSTON PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-338-5380
Mailing Address - Street 1:50 N PERRY ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2217
Mailing Address - Country:US
Mailing Address - Phone:248-338-5000
Mailing Address - Fax:248-338-5584
Practice Address - Street 1:50 N PERRY ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2217
Practice Address - Country:US
Practice Address - Phone:248-338-5000
Practice Address - Fax:248-338-5584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PONTIAC OSTEOPATHIC HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F31232OtherBLUE SHIELD GROUP PIN
MI0F31232OtherBLUE SHIELD GROUP PIN