# COLOMA EMERGENCY AMBULANCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pride Care Ambulance
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053347559
- **Authorized official:** MR. PATRICK O'NEILL (PRESIDENT / CEO)
- **Authorized official phone:** (269) 343-2224

## Contact information

- **Practice address:** 5088 MEREDITH ST, PORTAGE, MI 49002-2002
- **Practice address phone:** (269) 343-2224
- **Practice address fax:** (269) 343-6503
- **Mailing address:** PO BOX 2288, KALAMAZOO, MI 49003-2288
- **Mailing address phone:** (269) 343-2224
- **Mailing address fax:** (269) 343-6503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 111002 | MI | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 07/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 182675246 | — | MI |
| 05 | — | 2675246 | — | MI |
| 01 | — | 590A100510 | BCBS OF MICHIGAN | MI |