Healthcare Provider Details

I. General information

NPI: 1801761838
Provider Name (Legal Business Name): NORTHERN EMS AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 W M-80
KINCHELOE MI
49788-1624
US

IV. Provider business mailing address

PO BOX 547
WHEELING IL
60090-0547
US

V. Phone/Fax

Practice location:
  • Phone: 906-495-6062
  • Fax: 906-495-6139
Mailing address:
  • Phone: 906-495-6062
  • Fax: 336-791-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MS. RENEE ANN GRAY
Title or Position: ADMINISTRATIVE OFFICER
Credential: PARAMEDIC IC
Phone: 906-495-6062