MEDICARE: AMERICAN AMBULANCE COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	821002	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	59OH20009	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1285724047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN AMBULANCE COMPANY

Provider Business Mailing Address
First Line	:	1050 TRUMBULL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1939
Country	:	US
Telephone Number	:	313-961-0876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 TRUMBULL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1939
Country	:	US
Telephone Number	:	313-961-0876
Fax Number	:

Authorized Official
Title or Position	:	BILLING CLERK
Name	:	MRS. IRENDA ILENE LOCKHART
Credential	:
Telephone Number	:	313-961-0876

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	10/23/2007

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Directions to “AMERICAN AMBULANCE COMPANY ” Practice Location

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