Healthcare Provider Details
I. General information
NPI: 1790724656
Provider Name (Legal Business Name): CITY OF TAYLOR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23345 GODDARD RD
TAYLOR MI
48180-4163
US
IV. Provider business mailing address
PO BOX 2122
RIVERVIEW MI
48193-1122
US
V. Phone/Fax
- Phone: 734-374-1660
- Fax: 734-374-2742
- Phone: 800-926-6985
- Fax: 734-479-6319
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 821026 |
| License Number State | MI |
VIII. Authorized Official
Name:
STEVE
DOUGLAS
PORTIS
Title or Position: FIRE CHIEF
Credential:
Phone: 734-374-1355