# C M AMBULANCE SERVICE INC

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

## Provider details

- **NPI number:** 1689674962
- **Authorized official:** MICHELLE CHRISTINE LAKE (BILLING MANAGER)
- **Authorized official phone:** (810) 686-7600

## Contact information

- **Practice address:** 3370 W VIENNA RD, CLIO, MI 48420-1374
- **Practice address phone:** (810) 686-7600
- **Practice address fax:** (810) 686-6017
- **Mailing address:** 3370 W VIENNA RD, CLIO, MI 48420-1374
- **Mailing address phone:** (810) 686-7600
- **Mailing address fax:** (810) 686-6017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 251001 | MI | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 03/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3000031 | — | MI |
| 01 | — | 590B500210 | BLUECROSS BLUESHIELD | MI |