Healthcare Provider Details

I. General information

NPI: 1578503959
Provider Name (Legal Business Name): CHARTER TOWNSHIP OF HARRISON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39460 JEFFERSON AVE
HARRISON TOWNSHIP MI
48045-1823
US

IV. Provider business mailing address

PO BOX 2122
RIVERVIEW MI
48193-1122
US

V. Phone/Fax

Practice location:
  • Phone: 586-466-1450
  • Fax: 734-479-6319
Mailing address:
  • Phone: 734-224-4474
  • Fax: 734-479-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number501006
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DAVID BOSTATER
Title or Position: FIRE CHIEF
Credential:
Phone: 586-466-1450