MEDICARE: FIFE LAKE AREA AMBULANCE AUTHORITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00208624	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590D010060	OTHER	MI	BCBS OF MICHIGAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326267006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIFE LAKE AREA AMBULANCE AUTHORITY

Provider Business Mailing Address
First Line	:	P.O. BOX 216
Second Line	:
City	:	FIFE LAKE
State	:	MI
Zip	:	49633
Country	:	US
Telephone Number	:	231-879-4009
Fax Number	:	231-879-3146

Provider Business Practice Location Address
First Line	:	134 MORGAN ST
Second Line	:
City	:	FIFE LAKE
State	:	MI
Zip	:	49633
Country	:	US
Telephone Number	:	231-879-4009
Fax Number	:	231-897-3146

Authorized Official
Title or Position	:	TREASURER
Name	:	MS. JUDITH G. HOUTS
Credential	:
Telephone Number	:	231-357-5442

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/21/2011

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Directions to “FIFE LAKE AREA AMBULANCE AUTHORITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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