Organization
MARSHALL AREA FIREFIGHTERS AMBULANCE AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK JACOB SMITH (EXECUTIVE DIRECTOR)
(269) 781-9819
Entity
Organization
Contact information
Practice address
16984 BURLINGAME DR, MARSHALL, MI 49068-8422
(269) 781-9819
(269) 781-9323
Mailing address
16984 BURLINGAME DR, MARSHALL, MI 49068-8422
(269) 781-9819
(269) 781-9323
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
131005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4651726
—
MI
01
—
OA31110
BLUE CROSS BLUE SHIELD MI
MI
01
—
P45549
BLUE CARE NETWORK
MI
Enumeration date
06/30/2005
Last updated
03/18/2021
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