Northern Bay Ambulance and Rescue Service of Michigan
Organization Active NPI Land Ambulance · Pinconning, MI
NPI 1720137201 · NPPES record last updated Feb 13, 2025
Key facts
- NPI
- 1720137201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- NORTHERN BAY AMBULANCE AND RESCUE SERVICE OF MICHIGAN
- Practice address
- 325 S. Libby St
Pinconning, MI 48650-8400 - Phone
- (810) 853-3682
- Fax
- (989) 879-2220
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Paul Lee Boss
- Title
- Acting Director
- Phone
- (810) 853-3682
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1053216 | Northern Bay Ambulance and Rescue | Certificate of waiver | Apr 17, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120328000864 | MI | Part B Supplier - Ambulance Service Supplier | 4284894254 | Practice locations: Pinconning, MI |
National Provider Directory
Locations
325 Libby St
Pinconning, MI 48650
Phone (989) 879-2220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 091002 | MI | |
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
325 S. Libby St
Pinconning, MI 48650-8400
Mailing address
PO Box 2122
Riverview, MI 48193-1122
Phone (734) 224-4474
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0Z90008 | Other | MI | BCBSM |
| 3002949 | Medicaid | MI |
Other names
- Northern Bay Ambulance
Other providers in Pinconning, MI
- Angela Marie Merso
- Rhonda Renee Mesecar
- Carissa Meyers
- Christy Sue Morand
- Tammy Marie Neely
- Randy J O'Laughlin
- Michelle Marie Pickvet
- Pinconning Area Chiropractic Center Inc
- Pinconning Family Eye Care PC
- Pinconning Medical Center P.C.
All providers in Pinconning, 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 Feb 13, 2025. 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.