1831132695 NPI number — TOWNSHIP OF WINDSOR

Table of content: (NPI 1831132695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831132695 NPI number — TOWNSHIP OF WINDSOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSHIP OF WINDSOR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831132695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 LAKE LANSING RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48912-3798
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-485-0001
Provider Business Mailing Address Fax Number:
517-485-1138

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 W JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIMONDALE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48821-9551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-646-0772
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ST CLAIR
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
Authorized Official Title or Position:
TOWNSHIP SUPERVISOR
Authorized Official Telephone Number:
517-646-0772

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  231008 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 590B30015 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1873220 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200000003603 . This is a "PHPMM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".