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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