Organization
SISTER LAKES FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAYLE TIDEY (PRESIDENT)
(269) 424-3145
Entity
Organization
Contact information
Practice address
92280 COUNTY ROAD 690, DOWAGIAC, MI 49047-9035
(269) 424-3145
(269) 424-5560
Mailing address
92280 COUNTY ROAD 690, DOWAGIAC, MI 49047-9035
(269) 424-3145
(269) 424-5560
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
801005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2789837
—
MI
01
—
590H000014
BCBS
—
Enumeration date
06/18/2006
Last updated
03/12/2010
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