Provider Demographics
NPI:1831117100
Name:FREDERIC TOWNSHIP
Entity Type:Organization
Organization Name:FREDERIC TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-348-8190
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:FREDERIC
Mailing Address - State:MI
Mailing Address - Zip Code:49733-0079
Mailing Address - Country:US
Mailing Address - Phone:989-348-8190
Mailing Address - Fax:
Practice Address - Street 1:6547 FREDERIC ST
Practice Address - Street 2:
Practice Address - City:FREDERIC
Practice Address - State:MI
Practice Address - Zip Code:49733-0079
Practice Address - Country:US
Practice Address - Phone:989-348-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI201002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B00003Medicare ID - Type UnspecifiedEMS