Sister Lakes Fire Department

Primary specialty

AmbulanceTaxonomy code 341600000X

License

801005 Issued in MI

Legal business name

SISTER LAKES FIRE DEPARTMENT

Practice address

92280 County Road 690
Dowagiac, MI 49047-9035

Phone

(269) 424-3145

Fax

(269) 424-5560

NPI assigned

Jun 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Gayle Tidey

Title

President

Phone

(269) 424-3145

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1366487753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92280 COUNTY ROAD 690",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490479035",
            "telephone_number": "269-424-3145",
            "fax_number": "269-424-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92280 COUNTY ROAD 690",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490479035",
            "telephone_number": "269-424-3145",
            "fax_number": "269-424-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTER LAKES FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "TIDEY",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-424-3145",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MI",
            "license": "801005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2789837",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "590H000014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy James Sayers, PA-C
• Denise Lynn Schue, RPH
• Elizabeth Sharp, LMT
• Shopko Stores Operating Co LLC
• Prakash Taujale Shrestha, M.D.
• Zana Smallen
• Lisa Marie Smith, PA
• Tearsa Smith
• Jamie Elizabeth Sobczak, DMD
• Marisa Sochacki, PHARMD

• Ambulance in Dowagiac, MI
• Providers in Dowagiac, MI by specialty
• Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.