1770911935 NPI number — NEW MILLENNIUM AMBULANCE SERVICE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770911935 NPI number — NEW MILLENNIUM AMBULANCE SERVICE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW MILLENNIUM AMBULANCE SERVICE 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:
1770911935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8015 OXFORDSHIRE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-4671
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-646-4780
Provider Business Mailing Address Fax Number:
888-200-6642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5504 BANDERA RD
Provider Second Line Business Practice Location Address:
608
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78238-1943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-646-4780
Provider Business Practice Location Address Fax Number:
888-200-6642
Provider Enumeration Date:
10/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MARTEL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
832-878-6759

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1000896 , 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)





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