Provider Demographics
NPI:1952605362
Name:BRIDGEPORT CHARTER TOWNSHIP FIRE DEPARTMENT
Entity Type:Organization
Organization Name:BRIDGEPORT CHARTER TOWNSHIP FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-777-2400
Mailing Address - Street 1:6204 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48722-9619
Mailing Address - Country:US
Mailing Address - Phone:989-777-2400
Mailing Address - Fax:989-777-0972
Practice Address - Street 1:6204 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:MI
Practice Address - Zip Code:48722-9619
Practice Address - Country:US
Practice Address - Phone:989-777-2400
Practice Address - Fax:989-777-0972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7310123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport