SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN INC NPI 1720046188

NPI Information

NPI: 1720046188
Provider Name: SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN, INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 23D1069398

Address:
2000 CENTERWOOD DR
WARREN, MI
ZIP 48091
Phone: (313) 832-8558
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SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN, INC is a land transport ambulance in Warren, MI. SUPERIOR AIR-GROUND AMBULANCE SERVICE OF MICHIGAN, INC NPI is 1720046188. The provider is registered as an organization entity type.

The provider's business location address is:

2000 CENTERWOOD DR
WARREN, MI
ZIP 48091
Phone: (313) 832-8558

The provider's authorized official is Kimberly Pate Godden .
The authorized official title is Vice President and has the following contact phone number (630) 903-2401.

The CLIA number assigned to this NPI record is 23D1069398 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 7/18/2018.

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	3416A0800X	Ambulance	Air Transport	501040	MICHIGAN	No
2	3416L0300X	Ambulance	Land Transport	501040	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	058738	OTHER	MICHIGAN	HAP(HEALTH ALLIANCE PLAN)
2	188077058	MEDICAID	MICHIGAN
3	0E01788	OTHER	MICHIGAN	BLUECROSS BLUESHIELD

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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