NPIMap

Organization Active NPI

Huron Medical Center P.C.

  • Community/Retail Pharmacy
  • Port Huron, MI
National Provider Identifier
1720745003
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HURON MEDICAL CENTER P.C.
Practice address
2605 Electric Ave
Port Huron, MI 48060-6590
Phone
(810) 824-4066
NPI assigned
Nov 22, 2021
Organization subpart
Yes
Parent organization
HURON MEDICAL PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Theresa Lynn Stiles
Title
Office Manager
Phone
(810) 982-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2605 Electric Ave
Port Huron, MI 48060-6590

Mailing address

1231 Pine Grove Ave Ste 2F
Port Huron, MI 48060-3500
Phone (810) 982-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220621002849 MI DME Supplier - Pharmacy 0648283929 Practice locations: Port Huron, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Huron Medical Center PC2605 Electric Ave, Port Huron, MI 48060-6590(810) 982-5200 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 17, 2002

National Provider Directory

National Provider Directory
Part of
Huron Medical Center PC

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1720745003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE STE 2F",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606590",
            "telephone_number": "810-824-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON MEDICAL CENTER P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HURON MEDICAL PHARMACY",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-982-5200"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.