Organization Name: | MICHAEL W WILSON |
NPI Number: | 1134298870 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL W WILSON (OWNER) |
Mailing Address: | 115 E Pearl St Winamac |
State: | IN US |
Postal Code: | 469961310 |
Phone Number: | 5749467226 |
Fax Number: | 5749464141 |
NPI Enumeration Date: | 11/07/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | 0786 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |