Michigan Area Ambulance Service, Inc
Organization Active NPI Ambulance · Michigan, ND
NPI 1962614461 · NPPES record last updated Dec 19, 2017
Key facts
- NPI
- 1962614461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 85 (ND)
- Legal business name
- MICHIGAN AREA AMBULANCE SERVICE, INC
- Practice address
- 117 Broadway
Michigan, ND 58259-0017 - Phone
- (701) 259-2299
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Jason M Flom
- Title
- Manager/Director
- Phone
- (701) 259-2299
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D2062604 | Michigan Area Ambulance Service, Inc | Certificate of waiver | Jul 17, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101208001357 | ND | Part B Supplier - Ambulance Service Supplier | 5092902627 | Practice locations: Michigan, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician |
146N00000X | 085 | ND | |
| Ambulance | 341600000X | 85 | ND | Yes |
Addresses
Primary practice location
117 Broadway
Michigan, ND 58259-0017
Mailing address
PO Box 17
117 Broadway
Michigan, ND 58259-0017
Phone (701) 259-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052971 | Medicaid | ND |
Other providers in Michigan, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2017. 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.