Provider Demographics
NPI:1316998909
Name:TRI - TOWNSHIP AMBULANCE SERVICE
Entity type:Organization
Organization Name:TRI - TOWNSHIP AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:VONOPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-785-4841
Mailing Address - Street 1:11413 PARLAND ST
Mailing Address - Street 2:P.O. BOX 275
Mailing Address - City:ATLANTA
Mailing Address - State:MI
Mailing Address - Zip Code:49709-9271
Mailing Address - Country:US
Mailing Address - Phone:989-785-4841
Mailing Address - Fax:989-785-4565
Practice Address - Street 1:11413 PARLAND ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:MI
Practice Address - Zip Code:49709-9271
Practice Address - Country:US
Practice Address - Phone:989-785-4841
Practice Address - Fax:989-785-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI601003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3002018Medicaid
MI590015231OtherRAILROAD MEDICARE
MI590F800040OtherBCBSM
MI3002018Medicaid