1043526379 NPI number — AA AMBULANCE SERVICES LLC

Table of content: (NPI 1043526379)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043526379 NPI number — AA AMBULANCE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AA AMBULANCE SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043526379
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2740
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANGLETON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77516-2740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-777-7733
Provider Business Mailing Address Fax Number:
713-661-2504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13087 S HIGHWAY 288B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANGLETON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77515-9660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-661-2500
Provider Business Practice Location Address Fax Number:
713-661-2504
Provider Enumeration Date:
08/24/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KELLY
Authorized Official First Name:
SHANE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
832-865-6626

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1000498 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)