Provider Demographics
NPI:1154472090
Name:NORTH ALERT EMS AMBULANCE AUTHORITY
Entity Type:Organization
Organization Name:NORTH ALERT EMS AMBULANCE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-563-5235
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49870-0173
Mailing Address - Country:US
Mailing Address - Phone:906-563-9961
Mailing Address - Fax:
Practice Address - Street 1:U S 2
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:MI
Practice Address - Zip Code:49870
Practice Address - Country:US
Practice Address - Phone:906-563-9961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI221007341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590B21001OtherBLUE CROSS BLUE SHIELD
MI4610376Medicaid
MI4610376Medicaid