Provider Demographics
NPI:1376579029
Name:TOWNSHIP OF BRANDON
Entity Type:Organization
Organization Name:TOWNSHIP OF BRANDON
Other - Org Name:BRANDON TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAPIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-627-4000
Mailing Address - Street 1:395 MILL ST
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-7704
Mailing Address - Country:US
Mailing Address - Phone:248-627-4000
Mailing Address - Fax:248-627-3181
Practice Address - Street 1:53 SOUTH ST
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48462-8530
Practice Address - Country:US
Practice Address - Phone:248-627-4000
Practice Address - Fax:248-627-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6310323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI184111456Medicaid
MI184111456Medicaid