South Haven Area Emergency Services Authority

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

801006 Issued in MI

Legal business name

SOUTH HAVEN AREA EMERGENCY SERVICES AUTHORITY

Practice address

90 Blue Star Hwy
South Haven, MI 49090-2411

Phone

(269) 637-5151

Fax

(269) 637-9346

NPI assigned

Jun 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brandon Hinz

Title

Executive Director/Fire Chief

Phone

(269) 639-1496

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729900800000",
    "number": "1023058542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BLUE STAR HWY",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490902411",
            "telephone_number": "269-637-5151",
            "fax_number": "269-637-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BLUE STAR HWY",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490902411",
            "telephone_number": "269-637-5151",
            "fax_number": "269-637-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HAVEN AREA EMERGENCY SERVICES AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A",
        "authorized_official_last_name": "HINZ",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/FIRE CHIEF",
        "authorized_official_telephone_number": "269-639-1496",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "801006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184434063",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "590012741",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew G Small, MD
• Scott Eric Smith, OTR
• Soma Medical Clinic, LLC
• Alisa A Somers, DPT
• South Coast Home LLC
• South Haven Chiropractic Clinic
• South Haven Community Health System
• South Haven Eyecare Associates
• South Haven Family Physicians, P.C.
• South Haven Opco, LLC

• Land Ambulance in South Haven, MI
• Providers in South Haven, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.