Glen Arbor Township

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

451002 Issued in MI

Legal business name

GLEN ARBOR TOWNSHIP

Doing business as

Glen Lake Fire Department

Practice address

6401 West State St
Glen Arbor, MI 49636

Phone

(231) 334-3279

NPI assigned

Nov 2, 2006

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan Ferguson

Title

Fire Chief

Phone

(231) 334-3279

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Glen Lake Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1528147519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 WEST STATE ST",
            "city": "GLEN ARBOR",
            "state": "MI",
            "postal_code": "49636",
            "telephone_number": "231-334-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 WEST STATE ST",
            "city": "GLEN ARBOR",
            "state": "MI",
            "postal_code": "49636",
            "telephone_number": "231-334-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ARBOR TOWNSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "231-334-3279"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "451002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004818",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "590D50006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Lake Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Cundiff, PT
• Kiernan Mark Dean-Hall
• Enhanced Physical Therapy Incorporated
• Heather Marie Ford, LMSW
• Keith Alan Gaede, R.PH.
• Charles J Kinzel, PHARMACIST
• Jessica A Myers, D.C.
• Revive Chiropractic, PLLC
• The Prescription Shop of Glen Arbor, Inc

• Land Ambulance in Glen Arbor, MI
• Providers in Glen Arbor, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.