Organization Active NPI

City of Wyandotte

  • Land Ambulance
  • Wyandotte, MI
National Provider Identifier
1013955608
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
CITY OF WYANDOTTE
Practice address
266 Maple St
Wyandotte, MI 48192-5929
Phone
(734) 324-4404
Fax
(734) 324-3058
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jeremy Moline
Title
Assistant Fire Chief
Phone
(734) 324-7254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

266 Maple St
Wyandotte, MI 48192-5929

Mailing address

PO Box 2122
Riverview, MI 48193-1122
Phone (734) 224-4474

Other identifiers 1

IdentifierTypeStateIssuer
183001253MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120322000661 MI Part B Supplier - Ambulance Service Supplier 0941460208 Practice locations: Wyandotte, MI

National Provider Directory

National Provider Directory

Locations

1093 Ford Ave
Wyandotte, MI 48192
Phone (734) 324-7252

266 Maple St
Wyandotte, MI 48192
Phone (734) 324-4404

3131 Biddle Ave
Wyandotte, MI 48192

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712448000000",
    "number": "1013955608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2122",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481931122",
            "telephone_number": "734-224-4474",
            "fax_number": "734-479-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 MAPLE ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925929",
            "telephone_number": "734-324-4404",
            "fax_number": "734-324-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WYANDOTTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "MOLINE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "ASSISTANT FIRE CHIEF",
        "authorized_official_telephone_number": "734-324-7254",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183001253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.