Healthcare Provider Details

I. General information

NPI: 1821107046
Provider Name (Legal Business Name): TOWNSHIP OF GROSSE ILE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24525 MERIDIAN RD
GROSSE ILE MI
48138-2149
US

IV. Provider business mailing address

9601 GROH RD
GROSSE ILE MI
48138-2171
US

V. Phone/Fax

Practice location:
  • Phone: 734-676-7157
  • Fax: 734-692-9694
Mailing address:
  • Phone: 734-676-7157
  • Fax: 734-692-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number821009
License Number StateMI

VIII. Authorized Official

Name: ANN DARZNIEK
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 734-676-4422