Provider Demographics
NPI:1548446735
Name:CHIPPEWA TOWNSHIP
Entity type:Organization
Organization Name:CHIPPEWA TOWNSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-274-5319
Mailing Address - Street 1:30014 W M-28
Mailing Address - Street 2:
Mailing Address - City:ECKERMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49728
Mailing Address - Country:US
Mailing Address - Phone:906-274-5319
Mailing Address - Fax:906-274-5319
Practice Address - Street 1:11033 S STRONGS ROAD
Practice Address - Street 2:
Practice Address - City:ECKERMAN
Practice Address - State:MI
Practice Address - Zip Code:49728
Practice Address - Country:US
Practice Address - Phone:906-274-5319
Practice Address - Fax:906-274-5319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171014341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N72950Medicare PIN