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NPI Code Detail

MEDICARE: CITY OF RIVER ROUGE FIRE DEPT

MEDICARE: CITY OF RIVER ROUGE FIRE DEPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance088308MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306828397
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF RIVER ROUGE FIRE DEPT
Provider Business Mailing Address
First Line : PO BOX 630
Second Line :
City : WYANDOTTE
State : MI
Zip : 48192-0630
Country : US
Telephone Number : 877-477-4946
Fax Number : 734-246-2990
Provider Business Practice Location Address
First Line : 10600 W JEFFERSON AVE
Second Line :
City : RIVER ROUGE
State : MI
Zip : 48218
Country : US
Telephone Number : 313-297-0001
Fax Number : 313-842-4212
Authorized Official
Title or Position : FIRE CHIEF
Name : DAVE CIERRILLO
Credential :
Telephone Number : 313-297-0001
Provider Enumeration Date : 11/16/2005
Last Update Date : 08/22/2020

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Directions to “CITY OF RIVER ROUGE FIRE DEPT ” Practice Location

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