CHEBOYGAN LIFE SUPPORT SYSTEMS INC NPI 1225059587

NPI Information

NPI: 1225059587
Provider Name: CHEBOYGAN LIFE SUPPORT SYSTEMS INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 23D2209361

Address:
536 RIGGS DR
CHEBOYGAN, MI
ZIP 49721
Phone: (231) 627-9348
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CHEBOYGAN LIFE SUPPORT SYSTEMS INC is a land transport ambulance in Cheboygan, MI. CHEBOYGAN LIFE SUPPORT SYSTEMS INC NPI is 1225059587. The provider is registered as an organization entity type.

The provider's business location address is:

536 RIGGS DR
CHEBOYGAN, MI
ZIP 49721-063
Phone: (231) 627-9348
Fax: (231) 627-1658

The provider's authorized official is Dallas Lee Hyde .
The authorized official title is Director Of Clss and has the following contact phone number (231) 627-9348.

The CLIA number assigned to this NPI record is 23D2209361 - other - county jail with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	161003	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1486558	MEDICAID	MICHIGAN
2	P42574	OTHER		BLUE CARE NETWORK
3	590A60009	OTHER	MICHIGAN	BLUE CROSS BLUE SHEILD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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