# CLINTON AREA AMBULANCE SERVICE AUTHORITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023046695
- **Authorized official:** LYNN CHARLES WEBER EMTP IC (DIRECTOR)
- **Authorized official phone:** (989) 227-5713

## Contact information

- **Practice address:** 1001 S OAKLAND ST, SAINT JOHNS, MI 48879-2305
- **Practice address phone:** (517) 227-5713
- **Mailing address:** PO BOX 203, SAINT JOHNS, MI 48879-0203
- **Mailing address phone:** (892) 275-7139
- **Mailing address fax:** (989) 224-7870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 191001 | MI | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 12/06/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200000000500 | PHPMM | — |
| 05 | — | 4737624 | — | MI |
| 01 | — | 590A910200 | BCBSM | MI |
| 01 | — | P00218396 | RAILROAD MEDICARE | — |