Provider Demographics
NPI:1427040559
Name:CITY OF THREE RIVERS
Entity Type:Organization
Organization Name:CITY OF THREE RIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:FIRE CHIEF
Authorized Official - Phone:269-278-3755
Mailing Address - Street 1:333 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-2124
Mailing Address - Country:US
Mailing Address - Phone:269-278-3755
Mailing Address - Fax:269-278-6808
Practice Address - Street 1:333 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2124
Practice Address - Country:US
Practice Address - Phone:269-278-3755
Practice Address - Fax:269-278-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3005270Medicaid
MI3005270Medicaid