1609011519 NPI number — PALM HEALTH SERVICES LLC

Table of content: (NPI 1609011519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609011519 NPI number — PALM HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PALM HEALTH 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:
ACE EMS
Provider Other Organization Name Type Code:
3
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:
1609011519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1333 ELDRIGDE PARKWAY DR
Provider Second Line Business Mailing Address:
APT 922
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77077-1616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-975-7800
Provider Business Mailing Address Fax Number:
713-975-7797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9894 BISSONNET ST
Provider Second Line Business Practice Location Address:
STE 250
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-8239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-975-7800
Provider Business Practice Location Address Fax Number:
713-975-7797
Provider Enumeration Date:
12/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ABDEL-RAHMAN
Authorized Official First Name:
FIRAS
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
713-975-7800

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  100116 , 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: 202391301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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