Provider Demographics
NPI:1124107115
Name:WHITEWATER TOWNSHIP
Entity type:Organization
Organization Name:WHITEWATER TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-267-5141
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-0159
Mailing Address - Country:US
Mailing Address - Phone:231-267-5141
Mailing Address - Fax:
Practice Address - Street 1:8380 OLD M-72
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690
Practice Address - Country:US
Practice Address - Phone:231-267-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI281008341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3004344Medicaid
MI590B800140OtherBLUE CROSS BLUE SHIELD
MI3004344Medicaid