Organization
PHELAN EMS INC
Active
Organization
PHELAN EMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYODELE SUNMOLA (PRESIDENT)
(646) 841-9077
Entity
Organization
Contact information
Practice address
5925 PHELAN BLVD # I, SUITE 160, BEAUMONT, TX 77706-6253
(646) 841-9077
(713) 771-5081
Mailing address
5925 PHELAN BLVD # I, SUITE 160, BEAUMONT, TX 77706-6253
(646) 841-9077
(713) 771-5081
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1000737
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000737
TEXAS DSHS
TX
Enumeration date
02/15/2012
Last updated
02/15/2012
Update your record
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