Provider Demographics
NPI:1821176926
Name:CITY OF ALLEN PARK
Entity Type:Organization
Organization Name:CITY OF ALLEN PARK
Other - Org Name:ALLEN PARK FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-928-1103
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 1:6730 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2529
Practice Address - Country:US
Practice Address - Phone:313-928-0024
Practice Address - Fax:313-928-1654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8210323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183407885Medicaid
MI183407885Medicaid