Provider Demographics
NPI:1417023664
Name:CHARTER TOWNSHIP OF HURON
Entity Type:Organization
Organization Name:CHARTER TOWNSHIP OF HURON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNETTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-753-4466
Mailing Address - Street 1:22950 HURON RIVER DR.
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48164-9791
Mailing Address - Country:US
Mailing Address - Phone:734-753-4466
Mailing Address - Fax:734-753-4111
Practice Address - Street 1:22950 HURON RIVER DR.
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:MI
Practice Address - Zip Code:48164-9791
Practice Address - Country:US
Practice Address - Phone:734-753-4466
Practice Address - Fax:734-753-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821016341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2719921Medicaid
MI0H20102Medicare ID - Type Unspecified