Provider Demographics
NPI:1164519948
Name:WRIGHT-WALDRON FIRE & AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:WRIGHT-WALDRON FIRE & AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-286-6611
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:P.O. BOX 180
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1122
Mailing Address - Country:US
Mailing Address - Phone:734-479-6300
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:112 E CENTER ST
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:MI
Practice Address - Zip Code:49288-9814
Practice Address - Country:US
Practice Address - Phone:517-286-6611
Practice Address - Fax:517-286-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3010053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P00060Medicare PIN