Provider Demographics
NPI:1205242294
Name:PENNFIELD TWP FIRE DEPT
Entity type:Organization
Organization Name:PENNFIELD TWP FIRE DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-968-1920
Mailing Address - Street 1:20260 CAPITAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9727
Mailing Address - Country:US
Mailing Address - Phone:269-968-1920
Mailing Address - Fax:269-968-1889
Practice Address - Street 1:20260 CAPITAL AVE NE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-9727
Practice Address - Country:US
Practice Address - Phone:269-968-1920
Practice Address - Fax:269-968-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI01317146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty