Provider Demographics
NPI:1396822714
Name:TOWNSHIP OF ALMIRA
Entity Type:Organization
Organization Name:TOWNSHIP OF ALMIRA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-275-5862
Mailing Address - Street 1:7276 OLE WHITE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ANN
Mailing Address - State:MI
Mailing Address - Zip Code:49650-9617
Mailing Address - Country:US
Mailing Address - Phone:231-275-5862
Mailing Address - Fax:
Practice Address - Street 1:7276 OLE WHITE DR
Practice Address - Street 2:
Practice Address - City:LAKE ANN
Practice Address - State:MI
Practice Address - Zip Code:49650-9617
Practice Address - Country:US
Practice Address - Phone:231-275-5862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1010043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2779895Medicaid
MI590A000570OtherBLUE CROSS BLUE SHIELD
MI2779895Medicaid