Provider Demographics
NPI:1447428313
Name:NORTHEAST INGHAM EMERGENCY SERVICES AUTHORITY
Entity Type:Organization
Organization Name:NORTHEAST INGHAM EMERGENCY SERVICES AUTHORITY
Other - Org Name:WILLIAMSTON COMM FIRE BOARD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:YANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-655-3384
Mailing Address - Street 1:1296 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895-9771
Mailing Address - Country:US
Mailing Address - Phone:517-655-1383
Mailing Address - Fax:517-655-9384
Practice Address - Street 1:1296 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-9771
Practice Address - Country:US
Practice Address - Phone:517-655-1383
Practice Address - Fax:517-655-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI331009341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590C300150OtherBLUE CROSS
MI4070550Medicaid
MIP59230OtherBCN
MI81-09653OtherPHP
MI590C300150OtherBLUE CROSS