1750553582 NPI number — FAITH AMBULANCE SERVICE INC.

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 1750553582 NPI number — FAITH AMBULANCE SERVICE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAITH 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:
1750553582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2626 S. LOOP WEST
Provider Second Line Business Mailing Address:
SUITE 340
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054-5613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-669-1090
Provider Business Mailing Address Fax Number:
713-669-1091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9898 BISSONNET ST
Provider Second Line Business Practice Location Address:
SUITE 430P
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036-8270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-270-0766
Provider Business Practice Location Address Fax Number:
713-270-4757
Provider Enumeration Date:
04/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ODUNSI
Authorized Official First Name:
OLUSEGUN
Authorized Official Middle Name:
ADESHINA
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
713-270-0766

Provider Taxonomy Codes

  • Taxonomy code: 3416S0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1000116 . This is a "TEXAS DSHS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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