1720173867 NPI number — FIRST CHOICE AMBULANCE SERVICE, INC.

Table of content: (NPI 1720173867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720173867 NPI number — FIRST CHOICE AMBULANCE SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST CHOICE AMBULANCE SERVICE, INC.
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:
1720173867
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2646 S LOOP W STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054-2640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-664-8299
Provider Business Mailing Address Fax Number:
713-664-6262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2646 S LOOP W STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054-2640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-664-8299
Provider Business Practice Location Address Fax Number:
713-664-6262
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
713-664-8299

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  101264 , 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: 153859701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com