Provider Demographics
NPI:1811010416
Name:CITY OF DEARBORN HEIGHTS
Entity Type:Organization
Organization Name:CITY OF DEARBORN HEIGHTS
Other - Org Name:DEARBORN HEIGHTS FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-791-3650
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 1:1999 N BEECH DALY RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3487
Practice Address - Country:US
Practice Address - Phone:313-791-3650
Practice Address - Fax:313-791-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821004341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183001137Medicaid
MI590H200530OtherBLUE CROSS BLUE SHIELD