Provider Demographics
NPI:1396022109
Name:CITY OF TRAVERSE CITY
Entity Type:Organization
Organization Name:CITY OF TRAVERSE CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-922-4930
Mailing Address - Street 1:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-0592
Mailing Address - Country:US
Mailing Address - Phone:231-922-4930
Mailing Address - Fax:231-922-4872
Practice Address - Street 1:400 BOARDMAN AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2542
Practice Address - Country:US
Practice Address - Phone:231-922-4930
Practice Address - Fax:231-922-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2810133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport