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General NPI Number Information
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NPI Number | 1013952589
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Entity Type | Organization
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Legal Business Name | ROCKFORD AMBULANCE INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 8450 SHANER AVE NE
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City | ROCKFORD
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State | MI
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Zip | 49341-9379
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Country | US
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Telephone | 616-866-0724
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Fax | 616-866-3903
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Provider Business Mailing Address
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Address Line | 8450 SHANER AVE. NE
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City | ROCKFORD
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State | MI
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Zip | 49341
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Country | US
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Telephone | 616-866-0724
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Fax | 616-866-3903
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MRS. RISSIE HAACK
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Credential |
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Telephone | 616-866-0724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 411004
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License Number State | MI
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