Healthcare Provider Details

I. General information

NPI: 1760427132
Provider Name (Legal Business Name): COUNTY OF ALCONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E M 72
HARRISVILLE MI
48740-9715
US

IV. Provider business mailing address

2600 E M 72 P.O. BOX 308
HARRISVILLE MI
48740-9715
US

V. Phone/Fax

Practice location:
  • Phone: 989-736-3955
  • Fax: 989-736-8126
Mailing address:
  • Phone: 989-736-3955
  • Fax: 989-736-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number011001
License Number StateMI

VIII. Authorized Official

Name: MS. KRISTIN HOFFMAN
Title or Position: DIRECTOR
Credential:
Phone: 989-736-3955