Provider Demographics
NPI:1306875307
Name:OCEANA COUNTY CLERK
Entity type:Organization
Organization Name:OCEANA COUNTY CLERK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-873-8241
Mailing Address - Street 1:3966 N OCEANA DR
Mailing Address - Street 2:
Mailing Address - City:HART
Mailing Address - State:MI
Mailing Address - Zip Code:49420-8358
Mailing Address - Country:US
Mailing Address - Phone:231-873-8241
Mailing Address - Fax:
Practice Address - Street 1:3966 N OCEANA DR
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-8358
Practice Address - Country:US
Practice Address - Phone:231-873-4835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6410013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590F400070OtherBLUE CROSS BLUE SHIELD
MI3000111Medicaid
590058181OtherRAILROAD MEDICARE
MI590F400070OtherBLUE CROSS BLUE SHIELD