Healthcare Provider Details

I. General information

NPI: 1508931684
Provider Name (Legal Business Name): ARCHY'S & SONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4148 LEGION DR
MASON MI
48854-2546
US

IV. Provider business mailing address

4148 LEGION DR
MASON MI
48854-2546
US

V. Phone/Fax

Practice location:
  • Phone: 517-676-3023
  • Fax:
Mailing address:
  • Phone: 517-676-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number331012
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number331012
License Number StateMI

VIII. Authorized Official

Name: MR. KEVIN WAYNE AMMERMAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 517-676-3023