Provider Demographics
NPI:1184791139
Name:BINGHAM TOWNSHIP
Entity type:Organization
Organization Name:BINGHAM TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TREPKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-658-8651
Mailing Address - Street 1:2241 PIERCE STREET
Mailing Address - Street 2:
Mailing Address - City:UBLY
Mailing Address - State:MI
Mailing Address - Zip Code:48475
Mailing Address - Country:US
Mailing Address - Phone:989-658-8651
Mailing Address - Fax:
Practice Address - Street 1:2241 PIERCE STREET
Practice Address - Street 2:
Practice Address - City:UBLY
Practice Address - State:MI
Practice Address - Zip Code:48475
Practice Address - Country:US
Practice Address - Phone:989-658-8651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI321001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI59-0-C2-0017OtherBLUE CROSS/BLUE SHIELD OF MICHIGAN
MI183004738Medicaid
MI59-0-C2-0017OtherBLUE CROSS/BLUE SHIELD OF MICHIGAN