=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427040559
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF THREE RIVERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2005
-----------------------------------------------------
Last Update Date | 03/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 W MICHIGAN AVE
-----------------------------------------------------
City | THREE RIVERS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49093-2124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-278-3755
-----------------------------------------------------
Fax | 844-520-5968
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 W MICHIGAN AVE
-----------------------------------------------------
City | THREE RIVERS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49093-2124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-278-3755
-----------------------------------------------------
Fax | 844-520-5968
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FIRE CHIEF
-----------------------------------------------------
Name | PAUL SCHOON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 269-278-3755
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------