Healthcare Provider Details

I. General information

NPI: 1902021355
Provider Name (Legal Business Name): HIGGINS TOWNSHIP ROSCOMMON COUNTY MICH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SOUTH FIFTH STREET
ROSCOMMON MI
48653
US

IV. Provider business mailing address

PO BOX 2122
RIVERVIEW MI
48193-1122
US

V. Phone/Fax

Practice location:
  • Phone: 989-275-8112
  • Fax: 989-275-8990
Mailing address:
  • Phone: 734-479-6300
  • Fax: 734-479-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number721008
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MARK A GRACE
Title or Position: ASSISTANT FIRE AND EMS COORDINATOR
Credential:
Phone: 989-275-5229