MEDICARE: CHARTER TOWNSHIP OF HARRISON

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	501006	MI
2	3416L0300X	Land Ambulance

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

General Provider Information

NPI Number	:	1578503959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTER TOWNSHIP OF HARRISON

Provider Business Mailing Address
First Line	:	PO BOX 2122
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-1122
Country	:	US
Telephone Number	:	734-224-4474
Fax Number	:	734-479-6319

Provider Business Practice Location Address
First Line	:	39460 JEFFERSON AVE
Second Line	:
City	:	HARRISON TOWNSHIP
State	:	MI
Zip	:	48045-1823
Country	:	US
Telephone Number	:	586-466-1450
Fax Number	:	734-479-6319

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	DAVID BOSTATER
Credential	:
Telephone Number	:	586-466-1450

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	05/22/2024

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