Provider Demographics
NPI:1982644241
Name:TOWNSHIP OF REDFORD
Entity Type:Organization
Organization Name:TOWNSHIP OF REDFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIZZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-387-2648
Mailing Address - Street 1:PO BOX 40726
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-0726
Mailing Address - Country:US
Mailing Address - Phone:248-304-6016
Mailing Address - Fax:248-356-3234
Practice Address - Street 1:15145 BEECH DALY RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3201
Practice Address - Country:US
Practice Address - Phone:313-387-2648
Practice Address - Fax:313-387-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3220714Medicaid
MI0M20410Medicare PIN