Provider Demographics
NPI:1578767893
Name:TORCH LAKE TOWNSHIP
Entity Type:Organization
Organization Name:TORCH LAKE TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-599-2036
Mailing Address - Street 1:PO BOX 713
Mailing Address - Street 2:2355 US 31 N
Mailing Address - City:EASTPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49627-0713
Mailing Address - Country:US
Mailing Address - Phone:231-599-2174
Mailing Address - Fax:231-599-2174
Practice Address - Street 1:2355 US 31 N
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:MI
Practice Address - Zip Code:49627
Practice Address - Country:US
Practice Address - Phone:231-599-2174
Practice Address - Fax:231-599-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900016725OtherBCN
MI590Z5-00080OtherBCBS
MI183453289Medicaid
MI590Z5-00080OtherBCBS
MI183453289Medicaid