Healthcare Provider Details

I. General information

NPI: 1417929746
Provider Name (Legal Business Name): STOCKBRIDGE AREA AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S. CENTER ST
STOCKBRIDGE MI
49285-0336
US

IV. Provider business mailing address

PO BOX 336
STOCKBRIDGE MI
49285-0336
US

V. Phone/Fax

Practice location:
  • Phone: 517-851-7943
  • Fax: 517-851-7645
Mailing address:
  • Phone: 517-851-7943
  • Fax: 517-851-7645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number331008
License Number StateMI

VIII. Authorized Official

Name: JOHN E BECK
Title or Position: EMS DIRECTOR
Credential:
Phone: 517-851-7943