=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467414003
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAT EMERGENCY MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2006
-----------------------------------------------------
Last Update Date | 01/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 520 W 3RD ST
-----------------------------------------------------
City | FLINT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48503-2668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-238-7672
-----------------------------------------------------
Fax | 810-424-9921
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 520 W 3RD ST
-----------------------------------------------------
City | FLINT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48503-2668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-238-7672
-----------------------------------------------------
Fax | 810-424-9921
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AR MANAGER
-----------------------------------------------------
Name | MEREDITH ANN LUND
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 810-238-7672
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 251038
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------