Healthcare Provider Details

I. General information

NPI: 1235210246
Provider Name (Legal Business Name): SONCO AMBULANCE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5480 HIGHWAY M-28
BRUCE CROSSING MI
49912-0191
US

IV. Provider business mailing address

PO BOX 191
BRUCE CROSSING MI
49912-0191
US

V. Phone/Fax

Practice location:
  • Phone: 906-827-3598
  • Fax:
Mailing address:
  • Phone: 906-827-3598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number661001
License Number StateMI

VIII. Authorized Official

Name: MS. ARLENE M VLAHOS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 906-827-3598