Provider Demographics
NPI:1497790109
Name:COUNTY OF MONTCALM
Entity Type:Organization
Organization Name:COUNTY OF MONTCALM
Other - Org Name:MONTCALM COUNTY EMERGENCY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:D
Authorized Official - Last Name:FELDPAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:CCP, EMTP, PEM
Authorized Official - Phone:989-831-7583
Mailing Address - Street 1:211 W MAIN ST
Mailing Address - Street 2:PO BOX 368
Mailing Address - City:STANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48888-9690
Mailing Address - Country:US
Mailing Address - Phone:989-831-7580
Mailing Address - Fax:989-831-3535
Practice Address - Street 1:655 N STATE ST
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:MI
Practice Address - Zip Code:48888-9702
Practice Address - Country:US
Practice Address - Phone:989-831-7580
Practice Address - Fax:989-831-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5910013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3003454Medicaid
MI0E90012Medicare ID - Type Unspecified