Healthcare Provider Details

I. General information

NPI: 1922151208
Provider Name (Legal Business Name): SOUTHWEST SHIAWASSEE EMERGENCY SERVICES ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 S MAIN STREET
PERRY MI
48872
US

IV. Provider business mailing address

PO BOX 63
PERRY MI
48872-0063
US

V. Phone/Fax

Practice location:
  • Phone: 517-625-7611
  • Fax:
Mailing address:
  • Phone: 800-926-6985
  • Fax: 734-479-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number781010
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: TRENT M ATKINS
Title or Position: FIRE CHIEF
Credential:
Phone: 517-881-6279