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General NPI Number Information
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NPI Number | 1053347559
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Entity Type | Organization
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Legal Business Name | COLOMA EMERGENCY AMBULANCE, INC.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 5088 MEREDITH ST
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City | PORTAGE
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State | MI
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Zip | 49002-2002
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Country | US
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Telephone | 269-343-2224
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Fax | 269-343-6503
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Provider Business Mailing Address
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Address Line | PO BOX 2288
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City | KALAMAZOO
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State | MI
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Zip | 49003-2288
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Country | US
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Telephone | 269-343-2224
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Fax | 269-343-6503
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. PATRICK O'NEILL
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Credential |
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Telephone | 269-343-2224
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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 | 111002
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License Number State | MI
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