Organization
COLOMA EMERGENCY AMBULANCE, INC.
Active
Other names
Pride Care Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK O'NEILL (PRESIDENT / CEO)
(269) 343-2224
Entity
Organization
Contact information
Practice address
5088 MEREDITH ST, PORTAGE, MI 49002-2002
(269) 343-2224
(269) 343-6503
Mailing address
PO BOX 2288, KALAMAZOO, MI 49003-2288
(269) 343-2224
(269) 343-6503
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
111002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182675246
—
MI
05
—
2675246
—
MI
01
—
590A100510
BCBS OF MICHIGAN
MI
Enumeration date
06/25/2006
Last updated
07/28/2023
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