Healthcare Provider Details

I. General information

NPI: 1811084577
Provider Name (Legal Business Name): EASTERN HURON AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 NELSON ST
HARBOR BEACH MI
48441-1168
US

IV. Provider business mailing address

PO BOX 28
HARBOR BEACH MI
48441-0028
US

V. Phone/Fax

Practice location:
  • Phone: 989-479-0910
  • Fax: 989-479-0911
Mailing address:
  • Phone: 989-479-0910
  • Fax: 989-479-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number321002
License Number StateMI

VIII. Authorized Official

Name: MR. WARREN C. RAMSEY
Title or Position: MANAGER/IC
Credential: EMT
Phone: 989-479-0910