Provider Demographics
NPI:1760479307
Name:AKRON COLUMBIA WISNER AMBULANCE SERVICE
Entity Type:Organization
Organization Name:AKRON COLUMBIA WISNER AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-674-2416
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48767-0115
Mailing Address - Country:US
Mailing Address - Phone:810-793-4234
Mailing Address - Fax:810-793-4372
Practice Address - Street 1:6350 CENTER ST
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48767-9739
Practice Address - Country:US
Practice Address - Phone:989-674-2416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7910013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G9001Medicare PIN