Provider Demographics
NPI:1891874038
Name:VILLAGE OF ELKTON
Entity Type:Organization
Organization Name:VILLAGE OF ELKTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-375-2270
Mailing Address - Street 1:PO BOX 516
Mailing Address - Street 2:57 N MAIN ST
Mailing Address - City:ELKTON
Mailing Address - State:MI
Mailing Address - Zip Code:48731-0516
Mailing Address - Country:US
Mailing Address - Phone:989-375-2270
Mailing Address - Fax:989-375-4361
Practice Address - Street 1:57 N MAIN
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MI
Practice Address - Zip Code:48731-0516
Practice Address - Country:US
Practice Address - Phone:989-375-2270
Practice Address - Fax:989-375-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183003202Medicaid