# CORUNNA AREA AMBULANCE SERVICE INC

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

## Provider details

- **NPI number:** 1104013077
- **Authorized official:** BRIAN W MATTHIES CCEMT-P I/C (OPERATIONS MANAGER)
- **Authorized official phone:** (989) 743-3050

## Contact information

- **Practice address:** 610 N SHIAWASSEE ST, CORUNNA, MI 48817-1040
- **Practice address phone:** (989) 743-3050
- **Mailing address:** PO BOX 632964, CINCINNATI, OH 45263-2964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 088344 | MI | Yes |

## Other

- **Enumeration date:** 09/25/2007
- **Last updated:** 12/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200000008550 | PHPMM | MI |
| 05 | — | 3003839 | — | MI |
| 01 | — | 590045289 | RAILROAD MEDICARE | — |
| 01 | — | 590G800160 | BCBSM | MI |