1275527947 NPI number — METRO AMBULANCE, LP

Table of content: (NPI 1275527947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275527947 NPI number — METRO AMBULANCE, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METRO AMBULANCE, LP
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:
1275527947
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
129 COMMERCIAL PL.,
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHERTZ
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-288-2788
Provider Business Mailing Address Fax Number:
210-566-1330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
129 COMMERCIAL PL.,
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHERTZ
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-288-2788
Provider Business Practice Location Address Fax Number:
210-566-1330
Provider Enumeration Date:
09/08/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BECK
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
210-288-2788

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  094019 , 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)

  • Identifier: 5178568 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".