Provider Demographics
NPI:1073795704
Name:TOWNSHIP OF SUGAR ISLAND
Entity Type:Organization
Organization Name:TOWNSHIP OF SUGAR ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-635-5134
Mailing Address - Street 1:6401 EAST 1 1/2 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAULT STE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783
Mailing Address - Country:US
Mailing Address - Phone:906-253-9353
Mailing Address - Fax:
Practice Address - Street 1:6401 EAST 1 1/2 MILE RD
Practice Address - Street 2:
Practice Address - City:SAULT STE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783
Practice Address - Country:US
Practice Address - Phone:906-253-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171009341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0A70005Medicare PIN