Organization
PRIME HEALTHCARE SERVICES-PORT HURON LLC
Active
Other names
Lake Huron Medical Center
Organization subpart
No
Provider details
NPI number
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
(810) 216-1500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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