Active NPI
City of Wyandotte
- Land Ambulance
- Wyandotte, MI
National Provider Identifier
1013955608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183001253 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120322000661 | MI | Part B Supplier - Ambulance Service Supplier | 0941460208 | Practice locations: Wyandotte, MI |
National Provider Directory
National Provider DirectoryLocations
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.