MEDICARE: TWIN TOWNSHIP AMBULANCE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	781007	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	71020000G80017	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1063423473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN TOWNSHIP AMBULANCE, INC.

Provider Business Mailing Address
First Line	:	7900 SAGINAW ST
Second Line	:	P.O. BOX 303
City	:	NEW LOTHROP
State	:	MI
Zip	:	48460
Country	:	US
Telephone Number	:	810-634-1001
Fax Number	:	810-638-7424

Provider Business Practice Location Address
First Line	:	7900 SAGINAW ST
Second Line	:
City	:	NEW LOTHROP
State	:	MI
Zip	:	48460-9688
Country	:	US
Telephone Number	:	810-638-5034
Fax Number	:

Authorized Official
Title or Position	:	BILLING SPECIALIST
Name	:	JACQUELINE J HENIGE
Credential	:
Telephone Number	:	810-634-1001

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/24/2022

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