# SOUTH HAVEN AREA EMERGENCY SERVICES AUTHORITY

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

## Provider details

- **NPI number:** 1023058542
- **Authorized official:** MR. BRANDON HINZ (EXECUTIVE DIRECTOR/FIRE CHIEF)
- **Authorized official phone:** (269) 639-1496

## Contact information

- **Practice address:** 90 BLUE STAR HWY, SOUTH HAVEN, MI 49090-2411
- **Practice address phone:** (269) 637-5151
- **Practice address fax:** (269) 637-9346
- **Mailing address:** 90 BLUE STAR HWY, SOUTH HAVEN, MI 49090-2411
- **Mailing address phone:** (269) 637-5151
- **Mailing address fax:** (269) 637-9346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 801006 | MI | Yes |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 10/26/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 184434063 | — | MI |
| 01 | — | 590012741 | RAIL ROAD MEDICARE | MI |