Organization
LESLIE AREA AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE SUE SWIFT (BOOKKEEPER,BILLER)
(517) 589-9141
Entity
Organization
Contact information
Practice address
210 E BELLEVUE ST, LESLIE, MI 49251-9373
(517) 589-9141
(517) 589-9819
Mailing address
210 E BELLEVUE ST, PO BOX 461, LESLIE, MI 49251-9373
(517) 589-9141
(517) 589-9819
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
331005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81-09470
PHYSICIANS HEALTH PLAN
MI
01
—
OC30020
BLUECROSSBLUESHIELD
MI
Enumeration date
10/12/2005
Last updated
08/22/2020
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