PORT HURON FAMILY CARE PLLC NPI 1518118470

NPI Information

NPI: 1518118470
Provider Name: PORT HURON FAMILY CARE PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 23D0364135

Address:
1979 HOLLAND AVE
SUITE C
PORT HURON, MI
ZIP 48060
Phone: (810) 982-1200
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PORT HURON FAMILY CARE PLLC is a primary care clinic center in Port Huron, MI. PORT HURON FAMILY CARE PLLC NPI is 1518118470. The provider is registered as an organization entity type.

The provider's business location address is:

1979 HOLLAND AVE
SUITE C
PORT HURON, MI
ZIP 48060-639
Phone: (810) 982-1200
Fax: (810) 982-6990

The provider's authorized official is Kay L Robbins .
The authorized official title is Practice Manager and has the following contact phone number (810) 982-1200.

The CLIA number assigned to this NPI record is 23D0364135 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/8/2008 and was last updated on 1/5/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	DK035998	MICHIGAN	No
2	261QP2300X	Clinic/Center	Primary Care	JG075632	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	MICHIGAN	COMMERCIAL
2	G37739	MEDICARE UPIN	MICHIGAN
3	A76961	MEDICARE UPIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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