Organization
COUNTY OF MISSAUKEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SHARP (EMS DIRECTOR)
(231) 839-2198
Entity
Organization
Contact information
Practice address
404 FIRST STREET, LAKE CITY, MI 49651-0800
(231) 839-6101
(231) 839-2205
Mailing address
PO BOX 800, LAKE CITY, MI 49651-0800
(231) 335-7256
(231) 839-2205
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E70003
BLUE CROSS OF MICHIGAN
MI
05
—
3000274
—
MI
01
—
590058323
RAILROAD MEDICARE
MI
Enumeration date
05/17/2007
Last updated
11/02/2023
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