Provider Demographics
NPI:1538543160
Name:WAYNE COUNTY TREASURER PAYROLL-COUNTY OF WAYNE
Entity type:Organization
Organization Name:WAYNE COUNTY TREASURER PAYROLL-COUNTY OF WAYNE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHIS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:313-871-1926
Mailing Address - Street 1:9021 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3726
Mailing Address - Country:US
Mailing Address - Phone:313-871-1926
Mailing Address - Fax:313-871-1964
Practice Address - Street 1:33030 VAN BORN RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-2453
Practice Address - Country:US
Practice Address - Phone:313-871-1926
Practice Address - Fax:313-871-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)