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General NPI Number Information
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NPI Number | 1669524948
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Entity Type | Organization
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Legal Business Name | TOWNSHIP OF GREEN LAKE GRAND TRAVERSE COUNTY
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 9394 10TH ST
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City | INTERLOCHEN
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State | MI
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Zip | 49643
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Country | US
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Telephone | 231-276-6297
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Fax | 231-276-9388
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Provider Business Mailing Address
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Address Line | PO BOX 747
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City | WHEELING
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State | IL
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Zip | 60090-0747
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Country | US
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Telephone | 800-244-2345
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Fax | 800-329-5274
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Authorized Official
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Title or Position | FIRE CAPTAIN
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Name | MR. MICHAEL STINSON
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Credential |
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Telephone | 231-276-6297
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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 | 281005
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License Number State | MI
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