Organization
ELK RAPIDS TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN BOALS (TOWNSHIP CLERK)
(231) 264-9333
Entity
Organization
Contact information
Practice address
209 BRIDGE ST, ELK RAPIDS, MI 49629
(231) 264-9333
Mailing address
PO BOX 365, ELK RAPIDS, MI 49629-0365
(231) 264-9333
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
051005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3278474
—
MI
01
—
590D50005
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/02/2006
Last updated
01/16/2008
Update your record
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