Provider Demographics
NPI:1760427132
Name:COUNTY OF ALCONA
Entity Type:Organization
Organization Name:COUNTY OF ALCONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-736-3955
Mailing Address - Street 1:2600 E M 72
Mailing Address - Street 2:P.O. BOX 308
Mailing Address - City:HARRISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48740-9715
Mailing Address - Country:US
Mailing Address - Phone:989-736-3955
Mailing Address - Fax:989-736-8126
Practice Address - Street 1:2600 E M 72
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9715
Practice Address - Country:US
Practice Address - Phone:989-736-3955
Practice Address - Fax:989-736-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI011001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3000470Medicaid
MI3000470Medicaid