Provider Demographics
NPI:1437424066
Name:CLINTON AREA AMBULANCE SERVICE AUTHORITY
Entity Type:Organization
Organization Name:CLINTON AREA AMBULANCE SERVICE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-227-5713
Mailing Address - Street 1:1001 S OAKLAND ST
Mailing Address - Street 2:PO BOX 203
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-2305
Mailing Address - Country:US
Mailing Address - Phone:989-227-5713
Mailing Address - Fax:989-224-7870
Practice Address - Street 1:1001 S OAKLAND ST
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2305
Practice Address - Country:US
Practice Address - Phone:989-227-5713
Practice Address - Fax:989-224-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1910013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport