# ROCKFORD AMBULANCE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ROCKFORD AMBULANCE INC
- **Other names:** Lowell Ambulance, Sparta Ambulance, Grand Rapids Twp. Ambulance
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013952589
- **Legal business name:** ROCKFORD AMBULANCE INC
- **Authorized official:** MRS. RISSIE HAACK (OFFICE MANGER)
- **Authorized official phone:** (616) 866-0724

## Contact information

- **Practice address:** 8450 SHANER AVE NE, ROCKFORD, MI 49341-9379
- **Practice address phone:** (616) 866-0724
- **Practice address fax:** (616) 866-3903
- **Mailing address:** 8450 SHANER AVE. NE, ROCKFORD, MI 49341
- **Mailing address phone:** (616) 866-0724
- **Mailing address fax:** (616) 866-3903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 411004 | MI | Yes |
| 3416L0300X | Land Ambulance | — | NULL | — |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 12/02/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3001478 | — | MI |
| 01 | — | 590058353 | RAILROAD MEDICARE | MI |
| 01 | — | 590D10018 | BLUE CROSS BLUE SHIELD | MI |