Healthcare Provider Details

I. General information

NPI: 1588318760
Provider Name (Legal Business Name): CITY OF MARQUETTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 S 3RD ST
MARQUETTE MI
49855-4739
US

IV. Provider business mailing address

418 S 3RD ST
MARQUETTE MI
49855-4739
US

V. Phone/Fax

Practice location:
  • Phone: 906-225-8936
  • Fax:
Mailing address:
  • Phone: 96-225-8936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: CHASE STEVENS
Title or Position: FIREFIGHTER/PARAMEDIC
Credential:
Phone: 906-225-8936