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Organization
THORNAPPLE TOWNSHIP
Active
Organization
THORNAPPLE TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA KAVALUSKIS-BUCKOWING (TOWNSHIP TREASURER)
(269) 795-7202
Entity
Organization
Contact information
Practice address
128 HIGH STREET, MIDDLEVILLE, MI 49333-0459
(269) 795-3350
(269) 795-7051
Mailing address
128 HIGH STREET, PO BOX 459, MIDDLEVILLE, MI 49333-0459
(269) 795-3350
(269) 795-7051
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
081004
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3003697
—
MI
01
—
590Z80010
BCBSM
MI
01
—
990008613
RR MEDICARE
MI
Enumeration date
11/02/2006
Last updated
06/28/2012
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