Healthcare Provider Details

I. General information

NPI: 1417998923
Provider Name (Legal Business Name): CENTRAL HURON AMBULANCE ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 E SOPER RD
BAD AXE MI
48413-8379
US

IV. Provider business mailing address

291 E SOPER RD
BAD AXE MI
48413-8379
US

V. Phone/Fax

Practice location:
  • Phone: 989-269-7572
  • Fax:
Mailing address:
  • Phone: 989-269-7572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number321007
License Number StateMI

VIII. Authorized Official

Name: TIMOTHY ZUREK
Title or Position: DIRECTOR
Credential:
Phone: 989-269-7572