Healthcare Provider Details

I. General information

NPI: 1760479307
Provider Name (Legal Business Name): AKRON COLUMBIA WISNER AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 01/30/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 CENTER ST
UNIONVILLE MI
48767-9739
US

IV. Provider business mailing address

PO BOX 115
UNIONVILLE MI
48767-0115
US

V. Phone/Fax

Practice location:
  • Phone: 989-674-2416
  • Fax:
Mailing address:
  • Phone: 810-793-4234
  • Fax: 810-793-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number791001
License Number StateMI

VIII. Authorized Official

Name: MRS. JAMIE SCHUETTE
Title or Position: ADMIN CLERK
Credential:
Phone: 989-674-2416