Organization
CLINTON AREA AMBULANCE SERVICE AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN CHARLES WEBER EMTP IC (DIRECTOR)
(989) 227-5713
Entity
Organization
Contact information
Practice address
1001 S OAKLAND ST, SAINT JOHNS, MI 48879-2305
(517) 227-5713
Mailing address
PO BOX 203, SAINT JOHNS, MI 48879-0203
(892) 275-7139
(989) 224-7870
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
191001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000000500
PHPMM
—
05
—
4737624
—
MI
01
—
590A910200
BCBSM
MI
01
—
P00218396
RAILROAD MEDICARE
—
Enumeration date
06/30/2006
Last updated
12/06/2021
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