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General NPI Number Information
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NPI Number | 1881775351
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Entity Type | Organization
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Legal Business Name | TOWNSHIP BOARD OF SOUTH BRANCH
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 5245 N M-18
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City | ROSCOMMON
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State | MI
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Zip | 48653
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Country | US
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Telephone | 989-275-8232
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Fax | 989-275-5711
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Provider Business Mailing Address
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Address Line | PO BOX 2122
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City | RIVERVIEW
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State | MI
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Zip | 48193-1122
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Country | US
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Telephone | 734-479-6300
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Fax | 734-479-6319
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Authorized Official
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Title or Position | SUPERVISOR/SOUTH BRANCH TOWNSHIP
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Name | MS. LAURIE LUCK
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Credential |
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Telephone | 989-275-8232
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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 | 201004
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License Number State | MI
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