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Organization
BOANERGES
Active
Organization
BOANERGES
Active
Other names
Deerfield Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES NEWSON (OWNER/OPERATOR)
(810) 658-3865
Entity
Organization
Contact information
Practice address
320 S STATE RD, DAVISON, MI 48423-1510
(810) 658-3865
(810) 658-3865
Mailing address
PO BOX 402, LAPEER, MI 48446-0402
(810) 658-3865
(810) 658-3865
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
089034
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4115526
—
MI
01
—
590D40002
BCBS
MI
Enumeration date
10/25/2005
Last updated
08/22/2020
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