Provider Demographics
NPI:1881818912
Name:WASHINGTON TOWNSHIP
Entity Type:Organization
Organization Name:WASHINGTON TOWNSHIP
Other - Org Name:WASHINGTON TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TYRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-781-6161
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:800-826-6985
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:11300 27 MILE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-3955
Practice Address - Country:US
Practice Address - Phone:586-781-6161
Practice Address - Fax:586-781-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI341600000X341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183004148Medicaid