Provider Demographics
NPI:1982894218
Name:HURLEY MEDICAL CENTER
Entity Type:Organization
Organization Name:HURLEY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:APARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLABHANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-257-9000
Mailing Address - Street 1:24303 THORNRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9276
Mailing Address - Country:US
Mailing Address - Phone:810-695-1812
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL EDUCATION
Practice Address - Street 2:1 HURLEY PLAZA
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-257-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087261282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital