Provider Demographics
NPI:1114036464
Name:CITY OF WESTLAND AND 18TH DISTRICT COURT
Entity Type:Organization
Organization Name:CITY OF WESTLAND AND 18TH DISTRICT COURT
Other - Org Name:CITY OF WESTLAND FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT CHIEF/EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LACHOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-467-3251
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1122
Mailing Address - Country:US
Mailing Address - Phone:734-626-1861
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:35701 CENTRAL CITY PKWY
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-6753
Practice Address - Country:US
Practice Address - Phone:734-721-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8210293416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3001585Medicaid
MI0H20108Medicare PIN