Healthcare Provider Details

I. General information

NPI: 1912935651
Provider Name (Legal Business Name): COUNTY OF IOSCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 E US 23
EAST TAWAS MI
48730-9315
US

IV. Provider business mailing address

1808 E US 23
EAST TAWAS MI
48730-9315
US

V. Phone/Fax

Practice location:
  • Phone: 989-362-5534
  • Fax: 989-362-5059
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number35-1003
License Number StateMI

VIII. Authorized Official

Name: JAMIE CARRUTHERS-SOBOLESKI
Title or Position: COUNTY CONTROLLER/FINANCE DIRECTOR
Credential:
Phone: 989-984-1000