Healthcare Provider Details

I. General information

NPI: 1174567820
Provider Name (Legal Business Name): CITY OF MELVINDALE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 OAKWOOD BLVD
MELVINDALE MI
48122-1220
US

IV. Provider business mailing address

3100 OAKWOOD BLVD
MELVINDALE MI
48122-1220
US

V. Phone/Fax

Practice location:
  • Phone: 131-392-8752
  • Fax:
Mailing address:
  • Phone: 313-429-1040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number821020
License Number StateMI

VIII. Authorized Official

Name: STEVEN DENSMORE
Title or Position: FIRE CHIEF
Credential:
Phone: 13139287525