Provider Demographics
NPI:1467443978
Name:TOWNSHIP OF COVERT
Entity Type:Organization
Organization Name:TOWNSHIP OF COVERT
Other - Org Name:COVERT FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FOGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-764-5138
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:COVERT
Mailing Address - State:MI
Mailing Address - Zip Code:49043-0035
Mailing Address - Country:US
Mailing Address - Phone:269-764-8986
Mailing Address - Fax:269-764-1771
Practice Address - Street 1:33805 M-140 HWY
Practice Address - Street 2:
Practice Address - City:COVERT
Practice Address - State:MI
Practice Address - Zip Code:49043
Practice Address - Country:US
Practice Address - Phone:269-764-1768
Practice Address - Fax:269-764-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3416L0300X
MI8010023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590H000070OtherBCBS OF MI
MI590H00070OtherBCBSM
MI183001093Medicaid
MI590H00070OtherBCBSM