Provider Demographics
NPI:1629743331
Name:HURLEY MEDICAL CENTER
Entity Type:Organization
Organization Name:HURLEY MEDICAL CENTER
Other - Org Name:MOUD CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, PROFESSIONAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-262-9952
Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-262-9000
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical ToxicologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty