Organization
MRW MEDICAL TRANSPORT, LLC
Active
Other names
Premier EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MICAELA WOOTEN (CEO)
(210) 834-2559
Entity
Organization
Contact information
Practice address
3700 FREDERICKSBURG RD, SUITE 117, SAN ANTONIO, TX 78201-3269
(210) 226-1111
Mailing address
PO BOX 898, BUDA, TX 78610-0898
(210) 226-1111
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1000884
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01973471
AMERIGROUP
TX
01
—
0267885
WELLMED
TX
01
—
208286
SUPERIOR
TX
05
—
326568801
—
TX
Enumeration date
03/04/2013
Last updated
02/18/2016
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