Coloma Emergency Ambulance, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

111002 Issued in MI

Legal business name

COLOMA EMERGENCY AMBULANCE, INC.

Doing business as

Pride Care Ambulance

Practice address

5088 Meredith St
Portage, MI 49002-2002

Phone

(269) 343-2224

Fax

(269) 343-6503

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Patrick O'Neill

Title

President / Ceo

Phone

(269) 343-2224

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Pride Care Ambulance Doing business as

Locations

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1053347559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2288",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490032288",
            "telephone_number": "269-343-2224",
            "fax_number": "269-343-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5088 MEREDITH ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490022002",
            "telephone_number": "269-343-2224",
            "fax_number": "269-343-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLOMA EMERGENCY AMBULANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "269-343-2224",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "111002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "590A100510",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182675246",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2675246",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Care Ambulance",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pride Care Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Portage, MI
• Providers in Portage, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.