Healthcare Provider Details

I. General information

NPI: 1326267006
Provider Name (Legal Business Name): FIFE LAKE AREA AMBULANCE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 MORGAN ST
FIFE LAKE MI
49633
US

IV. Provider business mailing address

P.O. BOX 216
FIFE LAKE MI
49633
US

V. Phone/Fax

Practice location:
  • Phone: 231-879-4009
  • Fax: 231-897-3146
Mailing address:
  • Phone: 231-879-4009
  • Fax: 231-879-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MS. JUDITH G. HOUTS
Title or Position: TREASURER
Credential:
Phone: 231-357-5442