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Organization
TOWNSHIP OF PENINSULA
Active
Organization
TOWNSHIP OF PENINSULA
Active
Other names
PENINSULA TOWNSHIP EMERGENCY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT MANIGOLD (SUPERVISOR)
(231) 223-7322
Entity
Organization
Contact information
Practice address
13235 CENTER RD, TRAVERSE CITY, MI 49686-8560
(231) 223-7322
Mailing address
13235 CENTER RD, TRAVERSE CITY, MI 49686-8560
(231) 223-7322
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
281007
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590B801840
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
04/28/2011
Last updated
02/08/2012
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