Healthcare Provider Details
I. General information
NPI: 1679784250
Provider Name (Legal Business Name): TOWNSHIP OF ADRIAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2007
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2889 TIPTON HWY
ADRIAN MI
49221-9218
US
IV. Provider business mailing address
PO BOX 2122
RIVERVIEW MI
48193-1122
US
V. Phone/Fax
- Phone: 517-265-1314
- Fax: 517-266-1672
- Phone: 734-479-6300
- Fax: 734-479-6319
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 461013 |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
TIM
BARTENSLAGER
JR.
Title or Position: FIRE CHIEF
Credential:
Phone: 517-265-1314