MEDICARE: CITY OF MADISON HEIGHTS

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	341600000X	Ambulance	63 1009	MI
2	3416L0300X	Land Ambulance	631009	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	590F300620	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1073558094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF MADISON HEIGHTS

Provider Business Mailing Address
First Line	:	300 W 13 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1853
Country	:	US
Telephone Number	:	248-837-2833
Fax Number	:	248-588-3604

Provider Business Practice Location Address
First Line	:	31313 BRUSH ST
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1847
Country	:	US
Telephone Number	:	248-837-2833
Fax Number	:	248-588-3604

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	GREGORY LELITO
Credential	:
Telephone Number	:	248-837-2833

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	05/29/2026

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Directions to “CITY OF MADISON HEIGHTS ” Practice Location

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