| Port Huron Family Care Pllc | |
|
1979 Holland Ave Suite C Port Huron MI 48060-8639 | |
| (810) 982-1200 | |
| (810) 982-6990 |
| Full Name | Port Huron Family Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1979 Holland Ave, Port Huron, Michigan |
| Authorized Official Name and Position | Kay L Robbins (PRACTICE MANAGER) |
| Authorized Official Contact | 8109821200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Huron Family Care Pllc 1979 Holland Ave Suite C Port Huron MI 48060-8639 Ph: (810) 982-1200 | Port Huron Family Care Pllc 1979 Holland Ave Suite C Port Huron MI 48060-8639 Ph: (810) 982-1200 |
| NPI Number | 1518118470 |
|---|---|
| Provider Enumeration Date | 10/08/2008 |
| Last Update Date | 01/05/2010 |
| Medicare PECOS PAC ID | 0244395655 |
|---|---|
| Medicare Enrollment ID | O20090219000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518118470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | JG075632 (Michigan) | Primary |
| 261QP2300X | Clinic/center - Primary Care | DK035998 (Michigan) | Secondary |
| Provider Name | Jun A Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750356325 PECOS PAC ID: 8921057613 Enrollment ID: I20050120000238 |
| Provider Name | Justine M Schrader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003285859 PECOS PAC ID: 1052696622 Enrollment ID: I20170322000406 |
| Provider Name | Racheal Rose Jamison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619633625 PECOS PAC ID: 3971970799 Enrollment ID: I20221108003045 |
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