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Organization

SOUTH HAVEN AREA EMERGENCY SERVICES AUTHORITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRANDON HINZ (EXECUTIVE DIRECTOR/FIRE CHIEF)
(269) 639-1496
Entity
Organization

Contact information

Practice address
90 BLUE STAR HWY, SOUTH HAVEN, MI 49090-2411
(269) 637-5151
(269) 637-9346
Mailing address
90 BLUE STAR HWY, SOUTH HAVEN, MI 49090-2411
(269) 637-5151
(269) 637-9346

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
801006
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
184434063
MI
01
590012741
RAIL ROAD MEDICARE
MI
Enumeration date
06/07/2006
Last updated
10/26/2024
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