# COUNTY OF MISSAUKEE

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

## Provider details

- **NPI number:** 1760699789
- **Authorized official:** NICOLE SHARP (EMS DIRECTOR)
- **Authorized official phone:** (231) 839-2198

## Contact information

- **Practice address:** 404 FIRST STREET, LAKE CITY, MI 49651-0800
- **Practice address phone:** (231) 839-6101
- **Practice address fax:** (231) 839-2205
- **Mailing address:** PO BOX 800, LAKE CITY, MI 49651-0800
- **Mailing address phone:** (231) 335-7256
- **Mailing address fax:** (231) 839-2205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 11/02/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0E70003 | BLUE CROSS OF MICHIGAN | MI |
| 05 | — | 3000274 | — | MI |
| 01 | — | 590058323 | RAILROAD MEDICARE | MI |