Healthcare Provider Details

I. General information

NPI: 1114004892
Provider Name (Legal Business Name): CASTLETON-MAPLE GROVE-NASHVILLE AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N MAIN ST
NASHVILLE MI
49073-9578
US

IV. Provider business mailing address

PO BOX 280
NASHVILLE MI
49073-0280
US

V. Phone/Fax

Practice location:
  • Phone: 517-852-9385
  • Fax: 269-747-6066
Mailing address:
  • Phone: 517-852-9385
  • Fax: 269-747-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number081002
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number081002
License Number StateMI

VIII. Authorized Official

Name: WILLIAM MELVIN OAKLEY III
Title or Position: DIRECTOR
Credential:
Phone: 517-852-9385