Healthcare Provider Details

I. General information

NPI: 1508804055
Provider Name (Legal Business Name): TOWNSHIP OF GERRISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2997 E HIGGINS LAKE DR
ROSCOMMON MI
48653-7622
US

IV. Provider business mailing address

2997 E HIGGINS LAKE DR
ROSCOMMON MI
48653-7622
US

V. Phone/Fax

Practice location:
  • Phone: 989-821-9813
  • Fax: 989-821-8627
Mailing address:
  • Phone: 989-821-9813
  • Fax: 989-821-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number341600000X
License Number StateMI

VIII. Authorized Official

Name: JAMES FISHER JR.
Title or Position: FIRE CHIEF
Credential:
Phone: 989-821-9813