Provider Demographics
NPI:1790724656
Name:CITY OF TAYLOR
Entity Type:Organization
Organization Name:CITY OF TAYLOR
Other - Org Name:TAYLOR FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:PORTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-374-1355
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1122
Mailing Address - Country:US
Mailing Address - Phone:800-926-6985
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:23345 GODDARD RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4163
Practice Address - Country:US
Practice Address - Phone:734-374-1660
Practice Address - Fax:734-374-2742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8210263416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183005430Medicaid
MI590013724OtherRAILROAD MEDICARE
MI590H201190OtherBCBS OF MICHIGAN
MI590013724OtherRAILROAD MEDICARE