Organization
MICHAEL W WILSON
Active
Other names
Alliance EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W WILSON (OWNER)
(574) 946-7226
Entity
Organization
Contact information
Practice address
115 E PEARL ST, WINAMAC, IN 46996-1310
(574) 946-7226
(574) 946-4141
Mailing address
115 E PEARL ST, WINAMAC, IN 46996-1310
(574) 946-7226
(574) 946-4141
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0786
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217822
ANTHEM BCBS
IN
Enumeration date
11/07/2006
Last updated
08/22/2020
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