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General NPI Number Information
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NPI Number | 1558453845
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Entity Type | Organization
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Legal Business Name | COUNTY OF MECOSTA
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 14485 NORTHLAND DR
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City | BIG RAPIDS
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State | MI
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Zip | 49307-2368
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Country | US
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Telephone | 231-796-2626
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Fax | 231-796-0231
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Provider Business Mailing Address
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Address Line | 14485 NORTHLAND DRIVE
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City | BIG RAPIDS
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State | MI
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Zip | 49307-2368
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Country | US
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Telephone | 231-796-2626
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Fax | 231-796-0231
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | CRAIG LAWRENCE JOHNSON
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Credential |
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Telephone | 231-796-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 541001
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License Number State | MI
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