Organization
VILLAGE OF DETOUR
Active
Other names
DeTour Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA MARIE FISHER (CLERK)
(906) 297-5471
Entity
Organization
Contact information
Practice address
206 S ONTARIO STREET, DETOUR, MI 49725
(906) 297-5471
(906) 297-2107
Mailing address
260 S SUPERIOR STREET, PO BOX 397, DETOUR, MI 49725
(906) 297-5471
(906) 297-2107
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
17 1002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3001709
—
MI
01
—
OA70003
BLUE CROSS OF MICHIGAN
MI
Enumeration date
08/06/2007
Last updated
08/06/2007
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