Provider Demographics
NPI:1780759803
Name:SEBEWAING TOWNSHIP
Entity type:Organization
Organization Name:SEBEWAING TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-883-2120
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:14 SHARPSTEEN
Mailing Address - City:SEBEWAING
Mailing Address - State:MI
Mailing Address - Zip Code:48759
Mailing Address - Country:US
Mailing Address - Phone:989-883-2503
Mailing Address - Fax:989-883-2515
Practice Address - Street 1:10 SHARPSTEEN ST
Practice Address - Street 2:
Practice Address - City:SEBEWAING
Practice Address - State:MI
Practice Address - Zip Code:48759
Practice Address - Country:US
Practice Address - Phone:989-883-2120
Practice Address - Fax:989-883-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
MI321005341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183001119Medicaid
ON28500Medicare ID - Type Unspecified