Provider Demographics
NPI:1699713768
Name:CITY OF MONROE
Entity type:Organization
Organization Name:CITY OF MONROE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-241-1626
Mailing Address - Street 1:75 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-2142
Mailing Address - Country:US
Mailing Address - Phone:734-241-1626
Mailing Address - Fax:734-241-5347
Practice Address - Street 1:75 SCOTT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-2142
Practice Address - Country:US
Practice Address - Phone:734-241-1626
Practice Address - Fax:734-241-5347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI581011341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI184235355Medicaid
MI0N24550Medicare ID - Type Unspecified