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General NPI Number Information
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NPI Number | 1023046695
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Entity Type | Organization
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Legal Business Name | CLINTON AREA AMBULANCE SERVICE AUTHORITY
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 1001 S OAKLAND ST
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City | SAINT JOHNS
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State | MI
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Zip | 48879-2305
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Country | US
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Telephone | 517-227-5713
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 203
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City | SAINT JOHNS
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State | MI
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Zip | 48879-0203
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Country | US
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Telephone | 892-275-7139
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Fax | 989-224-7870
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Authorized Official
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Title or Position | DIRECTOR
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Name | LYNN CHARLES WEBER
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Credential | EMTP IC
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Telephone | 989-227-5713
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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 | 191001
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License Number State | MI
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