# COMMUNITY EMERGENCY SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDIC 1 AMBULANCE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619932415
- **Authorized official:** MR. JACK FISHER JR. (DIRECTOR)
- **Authorized official phone:** (269) 925-2144

## Contact information

- **Practice address:** 635 E NAPIER AVE, BENTON HARBOR, MI 49022-5813
- **Practice address phone:** (269) 925-2144
- **Practice address fax:** (269) 926-1139
- **Mailing address:** PO BOX 1563, 635 E. NAPIER AVE., BENTON HARBOR, MI 49023-1563
- **Mailing address phone:** (269) 925-2144
- **Mailing address fax:** (269) 926-1139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 111003 | MI | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3004228 | — | MI |