# EAST BAY CHARTER TOWNSHIP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EAST BAY CHARTER TOWNSHIP
- **Other names:** East Bay Ambulance
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306997598
- **Legal business name:** EAST BAY CHARTER TOWNSHIP
- **Authorized official:** NICHOLAS LEMCOOL (AMBULANCE DIRECTOR)
- **Authorized official phone:** (231) 947-0299

## Contact information

- **Practice address:** 110 HIGH LAKE RD, TRAVERSE CITY, MI 49686-8136
- **Practice address phone:** (231) 947-0299
- **Practice address fax:** (231) 947-0602
- **Mailing address:** 110 HIGH LAKE RD, TRAVERSE CITY, MI 49696-8136
- **Mailing address phone:** (231) 947-0299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 28 1001 | MI | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 07/31/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2968239 | — | MI |
| 01 | — | 590009133 | RAILROAD MEDICARE | — |