# CITY OF EAST JORDAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558428177
- **Authorized official:** MR. GERALD JAY PECK PARAMEDIC IC AAS (DIRECTOR)
- **Authorized official phone:** (231) 536-7881

## Contact information

- **Practice address:** 201 MAIN STREET, EAST JORDAN, MI 49727
- **Practice address phone:** (231) 536-7881
- **Practice address fax:** (231) 536-2785
- **Mailing address:** 201 MAIN STREET, PO BOX 499, EAST JORDAN, MI 49727
- **Mailing address phone:** (231) 536-7881
- **Mailing address fax:** (231) 536-2785

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 151003 | MI | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 11/10/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3001914 | — | MI |