PRIME HEALTHCARE SERVICES-PORT HURON LLC (NPI# 1184657884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184657884 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE SERVICES-PORT HURON LLC |
| Other Organization Name | LAKE HURON COMMUNITY PHARMACY |
| Practice Address |
2601 Electric Ave Port Huron MI 48060-6587 |
| Practice Telephone | 8102163140 |
| Practice Fax Number | 8102163145 |
| Mailing Telephone | 8102163140 |
| Mailing Fax Number | 8102163145 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | TRICIA MILLBRAND (DIRECTOR OF PHARMACY/PIC/BANK/AO) |
| Authorized Official Telephone | 8102163127 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301010709 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2154273 | 01 |
| Other Name | Type Code |
|---|---|
| Lake Huron Community Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407844 | Prime Healthcare Services-port Huron LLC | Radiology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-11-06 |
| 1912525361 | Prime Healthcare Services-port Huron LLC | Nurse Anesthetist, Certified Registered | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-07-13 |
| 1356723027 | Prime Healthcare Services-port Huron LLC | Rehabilitation Unit | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2015-06-18 |
| 1306227764 | Prime Healthcare Services-port Huron LLC | General Acute Care Hospital | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2015-06-11 |
| Street Address |
2601 ELECTRIC AVE |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-6587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174505069 | H Mcdonald Md, PC | Pathology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2005-11-16 |
| 1902407844 | Prime Healthcare Services-port Huron LLC | Radiology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-11-06 |
| 1013525070 | Serene Anesthesiology Pllc | Anesthesiology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-07-16 |
| 1912525361 | Prime Healthcare Services-port Huron LLC | Nurse Anesthetist, Certified Registered | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-07-13 |
| 1306460787 | Kyle W Doyle | Nurse Anesthetist, Certified Registered | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2020-06-02 |
| 1184272817 | Blue Water Rad Onc, LLC | Radiology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2019-08-27 |
| 1588121685 | Huron Pathology Associates Pllc | Pathology | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2019-02-25 |
| 1922571280 | Caillie Dianne Stephenson | Speech-Language Pathologist | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2019-01-09 |
| 1356812697 | Aaron T Misner | General Practice | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2018-12-16 |
| 1063987410 | Courtney Sherman | Occupational Therapist | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2018-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346349644 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 940 Lapeer Ave, Port Huron, MI 48060-4414 | 2006-09-22 |
| 1417069360 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 3530 Pine Grove Ave, Port Huron, MI 48060-1944 | 2006-08-31 |
| 1538187448 | Ehardt's Advanced Care Pharmacy | Pharmacy | 208 Huron Ave, Port Huron, MI 48060-3822 | 2006-07-18 |
| 1497791313 | Genoa Healthcare, LLC | Pharmacy | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2006-06-20 |
| 1629341102 | Port Huron Pharmacy, LLC | Pharmacy | 515 10th St, Port Huron, MI 48060-4404 | 2012-02-15 |
| 1306142914 | Downriver Community Services Inc | Pharmacy | 1011 Military St, Port Huron, MI 48060-5416 | 2011-01-28 |
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| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
| City | PORT HURON |
| Zip Code | 48060 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.