Provider Demographics
NPI:1689777237
Name:ONAWAY AREA AMBULANCE SERVICE
Entity Type:Organization
Organization Name:ONAWAY AREA AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-318-3756
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:ONAWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49765-0454
Mailing Address - Country:US
Mailing Address - Phone:989-733-4166
Mailing Address - Fax:989-733-8020
Practice Address - Street 1:20734 INDUSTRIAL PARK
Practice Address - Street 2:
Practice Address - City:ONAWAY
Practice Address - State:MI
Practice Address - Zip Code:49765
Practice Address - Country:US
Practice Address - Phone:989-733-4166
Practice Address - Fax:989-733-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7110023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3156865Medicaid
MI3156865Medicaid