Provider Demographics
NPI:1275578668
Name:DOWAGIAC VFD AMBULANCE
Entity Type:Organization
Organization Name:DOWAGIAC VFD AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-782-7656
Mailing Address - Street 1:103 PARK PL
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1766
Mailing Address - Country:US
Mailing Address - Phone:269-782-7656
Mailing Address - Fax:269-782-9941
Practice Address - Street 1:103 PARK PL
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1766
Practice Address - Country:US
Practice Address - Phone:269-782-7656
Practice Address - Fax:269-782-9941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI141002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3000087Medicaid
MI3000087Medicaid