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General NPI Number Information
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NPI Number | 1306848783
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Entity Type | Organization
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Legal Business Name | HOUGHTON LAKE AMBULANCE SERVICE
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 9166 W LAKE CITY RD.
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City | HOUGHTON LAKE
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State | MI
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Zip | 48629
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Country | US
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Telephone | 989-422-3312
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Fax | 989-422-6145
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Provider Business Mailing Address
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Address Line | PO BOX 746
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City | HOUGHTON LAKE
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State | MI
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Zip | 48629-0746
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Country | US
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Telephone | 989-422-3312
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Fax | 989-422-6145
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. SHEILA BLESSING
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Credential |
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Telephone | 989-422-3312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 721010
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License Number State | MI
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