Provider Demographics
NPI:1154370344
Name:COUNTY OF GENESEE OFFICE OF CONTROLLER
Entity type:Organization
Organization Name:COUNTY OF GENESEE OFFICE OF CONTROLLER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK II
Authorized Official - Prefix:
Authorized Official - First Name:TERA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-257-3104
Mailing Address - Street 1:630 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1525
Mailing Address - Country:US
Mailing Address - Phone:810-257-3155
Mailing Address - Fax:810-257-3147
Practice Address - Street 1:630 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1525
Practice Address - Country:US
Practice Address - Phone:810-257-3155
Practice Address - Fax:810-257-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI773149584Medicaid
MI3502517622OtherBCBS
MI772837685Medicaid
MI773149593Medicaid
0B51050Medicare ID - Type Unspecified
MI773149593Medicaid