Provider Demographics
NPI:1821107046
Name:TOWNSHIP OF GROSSE ILE
Entity Type:Organization
Organization Name:TOWNSHIP OF GROSSE ILE
Other - Org Name:GROSSE ILE TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARZNIEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-676-4422
Mailing Address - Street 1:9601 GROH RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-2171
Mailing Address - Country:US
Mailing Address - Phone:734-676-7157
Mailing Address - Fax:734-692-9694
Practice Address - Street 1:24525 MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138-2149
Practice Address - Country:US
Practice Address - Phone:734-676-7157
Practice Address - Fax:734-692-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821009341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590008985OtherRAIL ROAD MEDICARE
MI590H200190OtherBCBS OF MICHIGAN
MI182987207Medicaid
MI0H20019Medicare PIN