Healthcare Provider Details

I. General information

NPI: 1578504882
Provider Name (Legal Business Name): OGEMAW COUNTY EMERGENCY MEDICAL SERVICES AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2872 HANSEN RD
WEST BRANCH MI
48661-9317
US

IV. Provider business mailing address

PO BOX 399
WEST BRANCH MI
48661-0399
US

V. Phone/Fax

Practice location:
  • Phone: 989-345-4503
  • Fax:
Mailing address:
  • Phone: 989-345-4503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number651001
License Number StateMI

VIII. Authorized Official

Name: JUSTIN ROGERS
Title or Position: DIRECTOR
Credential:
Phone: 989-387-1961