Stockbridge Area Emergency Services Authority
Organization Active NPI Land Ambulance · Stockbridge, MI
NPI 1811060965 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1811060965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- STOCKBRIDGE AREA EMERGENCY SERVICES AUTHORITY
- Practice address
- 1009 S. Clinton
Stockbridge, MI 49285 - Phone
- (517) 851-7943
- Fax
- (517) 851-7645
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
Authorized official
- Name
- John Edward Beck
- Title
- General Manager
- Phone
- (517) 851-7943
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1040685 | Stockbridge Area Emergency Services Authority | Certificate of waiver | May 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070315000249 | MI | Part B Supplier - Ambulance Service Supplier | 3072616846 | Practice locations: Stockbridge, MI |
National Provider Directory
Locations
1009 S Clinton St
Stockbridge, MI 49285
Phone (517) 851-7943
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
1009 S. Clinton
Stockbridge, MI 49285
Mailing address
P.O. Box 728
125 S. Center St
Stockbridge, MI 49285
Phone (517) 851-7943
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0C30014 | Other | MI | BLUE CROSS BLUE SHIELD |
| 1777644 | Medicaid | MI |
Other names
- S.A.E.S.A.
Other providers in Stockbridge, MI
- Larry Ernest Porzsolt
- Jamie Rose
- Jessica Marilyn Shaw
- Shannon Sood
- Stockbridge Area Ambulance, Inc.
- Mark K Taylor
- Amanda Catherine Tilkins
- White Oak Dental PLLC
- Wright Care Services Inc
All providers in Stockbridge, 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 Sep 19, 2022. 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.