Healthcare Provider Details

I. General information

NPI: 1679517197
Provider Name (Legal Business Name): CITY OF FRASER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33000 GARFIELD RD
FRASER MI
48026-1858
US

IV. Provider business mailing address

PO BOX 2122
RIVERVIEW MI
48193-1122
US

V. Phone/Fax

Practice location:
  • Phone: 586-293-1425
  • Fax:
Mailing address:
  • Phone: 734-479-6300
  • Fax: 734-479-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number341600000X
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JOHN GILLIES
Title or Position: CAPTAIN/FIRE DIVISION COMMANDER
Credential:
Phone: 586-293-2000