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Organization

PRIME HEALTHCARE SERVICES-PORT HURON LLC

Active
Parent organization
PRIME HEALTHCARE SERVICES-PORT HURON LLC
Other names
Lake Huron Medical Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRIME HEALTHCARE SERVICES-PORT HURON LLC
Authorized official
CHRISTOPHER SCOTT FULKS (CFO)
(810) 216-1361
Entity
Organization

Contact information

Practice address
2601 ELECTRIC AVE, PORT HURON, MI 48060-6587
(810) 216-1500
Mailing address
2601 ELECTRIC AVE, PORT HURON, MI 48060-6587

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Enumeration date
11/06/2020
Last updated
02/02/2021
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