CHEBOYGAN LIFE SUPPORT SYSTEMS INC — NPI 1225059587 (Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance in CHEBOYGAN, MI)

CMS-1500 Box 24J / 33a • NPI

1225059587

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3416L0300X (CMS 59)

Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance

Box 32 Service Location & ZIP+4

536 RIGGS DR, CHEBOYGAN, MI, 49721-1063

✓ 9-Digit EDI 837 ZIP+4 (49721-1063)

Practice Phone & Referral Fax

(231) 627-9348

Fax: (231) 627-1658

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1225059587 (CHEBOYGAN LIFE SUPPORT SYSTEMS INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1225059587` (NPI-2 Organization / Facility)
Provider / Legal Name	CHEBOYGAN LIFE SUPPORT SYSTEMS INC
Plain-English Specialty	Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: `3416L0300X` (Ambulance, Land Transport)
Certifying / Licensing Body	State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Practice Location Address	536 RIGGS DR, CHEBOYGAN, MI, 49721-1063
Practice Telephone / Fax	Tel: (231) 627-9348 \| Fax: (231) 627-1658
Administrative Mailing Address	536 RIGGS DR, CHEBOYGAN, MI, 49721-1063
Enumeration & Last Sync	Enumerated: 2006-07-22 \| CMS Record Updated: 2020-08-22
Authorized Official	DALLAS HYDE (director of CLSS)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

536 RIGGS DR, CHEBOYGAN, MI, 49721-1063

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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)

What Does Taxonomy Code 3416L0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 59 (Ambulance Service Provider)
Certifying / Accrediting Authority: State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Clinical Scope: Emergency 911 pre-hospital medical response or medically supervised inter-hospital critical care transport.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CHEBOYGAN LIFE SUPPORT SYSTEMS INC)

Typical CPT / Diagnostic Procedures:

Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
Pre-Hospital Trauma Immobilization, Airway Management & IV Access

Common Therapeutic Classes:

Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3416L0300X` — Ambulance, Land Transport Plain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance	State: MI \| License: `161003` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CHEBOYGAN LIFE SUPPORT SYSTEMS INC (NPI #1225059587)