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General NPI Number Information
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NPI Number | 1730378993
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Entity Type | Organization
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Legal Business Name | MARENISCO AMBULANCE SERVICE
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 314 HALL STREET
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City | MARENISCO
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State | MI
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Zip | 49947
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Country | US
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Telephone | 906-787-2463
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Fax | 906-787-2244
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Provider Business Mailing Address
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Address Line | PO BOX 25
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City | MARENISCO
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State | MI
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Zip | 49947
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Country | US
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Telephone | 906-787-2463
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Fax | 906-787-2244
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Authorized Official
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Title or Position | DIRECTOR/CO-ORDINATOR
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Name | MRS. KAREN RAISANEN
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Credential |
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Telephone | 906-787-2463
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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 | 271002
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License Number State | MI
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