Provider Demographics
NPI:1417998923
Name:CENTRAL HURON AMBULANCE ASSOC
Entity Type:Organization
Organization Name:CENTRAL HURON AMBULANCE ASSOC
Other - Org Name:CENTRAL HURON AMBULANCE SERVICE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-269-7572
Mailing Address - Street 1:291 E SOPER RD
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-8379
Mailing Address - Country:US
Mailing Address - Phone:989-269-7572
Mailing Address - Fax:
Practice Address - Street 1:291 E SOPER RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-8379
Practice Address - Country:US
Practice Address - Phone:989-269-7572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI321007341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI183005548Medicaid
MI183005548Medicaid