Provider Demographics
NPI:1548208275
Name:CHARTER TOWNSHIP OF HIGHLAND
Entity type:Organization
Organization Name:CHARTER TOWNSHIP OF HIGHLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-887-9050
Mailing Address - Street 1:1600 W. HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4621
Mailing Address - Country:US
Mailing Address - Phone:248-887-9050
Mailing Address - Fax:248-889-9506
Practice Address - Street 1:1600 W. HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4621
Practice Address - Country:US
Practice Address - Phone:248-887-9050
Practice Address - Fax:248-889-9506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI631049341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590F300230OtherBCBS OF MI
MI184129737Medicaid
MI590F300230OtherBCBS OF MI