Healthcare Provider Details

I. General information

NPI: 1932262540
Provider Name (Legal Business Name): TOWNSHIP OF PALMYRA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4276 ROUGET RD
PALMYRA MI
49268
US

IV. Provider business mailing address

6490 PALMYRA RD
PALMYRA MI
49268-9789
US

V. Phone/Fax

Practice location:
  • Phone: 517-263-7394
  • Fax: 517-264-0354
Mailing address:
  • Phone: 517-263-7394
  • Fax: 517-264-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number341600000X
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE WHITED
Title or Position: CLERK
Credential:
Phone: 517-260-8628