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Organization
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Active
Organization
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Active
Parent organization
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Other names
Lakeshore Surgery Center, LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Authorized official
CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
(909) 235-4307
Entity
Organization
Contact information
Practice address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 989-7700
Mailing address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 989-7700
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
746818
MI
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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