Healthcare Provider Details

I. General information

NPI: 1356559033
Provider Name (Legal Business Name): MERCY EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23298 AIRPARK BLVD
CALUMET MI
49913-9233
US

IV. Provider business mailing address

23298 AIRPARK BLVD
CALUMET MI
49913-9233
US

V. Phone/Fax

Practice location:
  • Phone: 906-482-0932
  • Fax:
Mailing address:
  • Phone: 906-482-0932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number311002
License Number StateMI

VIII. Authorized Official

Name: JAMES S BOGAN
Title or Position: TREASURER
Credential:
Phone: 906-483-1500