Thornapple Township – Land Ambulance

Key facts

NPI: 1124107248
Entity type: Organization (NPI type 2)
Primary specialty: Land Ambulance 3416L0300X
License: 081004 (MI)
Legal business name: THORNAPPLE TOWNSHIP
Practice address: 128 High Street
Middleville, MI 49333-0459
Phone: (269) 795-3350
Fax: (269) 795-7051
NPI assigned: Nov 2, 2006
Organization subpart: No

Authorized official

Name: Ms. Debra Kavaluskis-Buckowing
Title: Township Treasurer
Phone: (269) 795-7202

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Willliam Royce Richardson Paramedic · Middleville, MI · NPI 1750162558

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
23D0890322	Thornapple Township Emergency Services 128 High Street, Middleville, MI 49333	Certificate of waiver	Aug 15, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20080916000274	MI	Part B Supplier - Ambulance Service Supplier	7214004365	Practice locations: Middleville, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Land Ambulance	3416L0300X	081004	MI	Yes

Addresses

Primary practice location

128 High Street
Middleville, MI 49333-0459

Mailing address

128 High Street
PO Box 459
Middleville, MI 49333-0459
Phone (269) 795-3350

Other identifiers

Identifier	Type	State	Issuer
990008613	Other	MI	RR MEDICARE
3003697	Medicaid	MI
590Z80010	Other	MI	BCBSM

Other providers in Middleville, MI

All providers in Middleville, MI · Land Ambulance in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.