Provider Demographics
NPI:1851874531
Name:HURLEY MEDICAL CENTER
Entity Type:Organization
Organization Name:HURLEY MEDICAL CENTER
Other - Org Name:HURLEY MEDICARE DIABETES PREVENTION PROGRAM (MDPP)
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, PROFESSIONAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKER
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:810-262-9255
Mailing Address - Fax:810-262-7317
Practice Address - Street 1:2700 ROBERT T LONGWAY BLVD STE G
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2190
Practice Address - Country:US
Practice Address - Phone:810-262-2310
Practice Address - Fax:810-235-2974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty