Provider Demographics
NPI:1629016274
Name:RICHMOND LENOX EMS AMBULANCE AUTHORITY
Entity Type:Organization
Organization Name:RICHMOND LENOX EMS AMBULANCE AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-727-2184
Mailing Address - Street 1:34505 32 MILE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-1557
Mailing Address - Country:US
Mailing Address - Phone:586-727-2184
Mailing Address - Fax:586-727-5050
Practice Address - Street 1:34505 32 MILE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1557
Practice Address - Country:US
Practice Address - Phone:586-727-2184
Practice Address - Fax:586-727-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E00005Medicare ID - Type UnspecifiedMEDICARE PROVIDER #