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General NPI Number Information
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NPI Number | 1255401410
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Entity Type | Organization
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Legal Business Name | TOWN OF REPUBLIC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 9610 STATE HWY M95
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City | REPUBLIC
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State | MI
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Zip | 49879
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Country | US
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Telephone | 906-376-8827
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Fax | 906-376-2383
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Provider Business Mailing Address
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Address Line | PO BOX 338
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City | REPUBLIC
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State | MI
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Zip | 49879-0338
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Country | US
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Telephone | 906-376-8827
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Fax | 906-376-2383
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI A BURTON
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Credential |
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Telephone | 906-376-8827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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