Provider Demographics
NPI:1386634863
Name:CITY OF INKSTER
Entity Type:Organization
Organization Name:CITY OF INKSTER
Other - Org Name:INKSTER FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:OLLICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-323-7438
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-0630
Mailing Address - Country:US
Mailing Address - Phone:877-477-4946
Mailing Address - Fax:734-246-2990
Practice Address - Street 1:27717 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-2203
Practice Address - Country:US
Practice Address - Phone:313-563-9874
Practice Address - Fax:313-563-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0848303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3002608Medicaid
MI590H20068OtherBCBS
MI3002608Medicaid