Organization
STATEWIDE EMS INC.
Active
Other names
Ultra Care Ambulane
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN M LOPEZ (BILLING AGENT)
(281) 777-9406
Entity
Organization
Contact information
Practice address
3123 PRESTON AVE, SUTIE B, PASADENA, TX 77505-2001
(832) 282-8867
Mailing address
3123 PRESTON AVE, SUTIE B, PASADENA, TX 77505-2001
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1000297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000297
STATE LICSENE
TX
Enumeration date
08/21/2009
Last updated
08/21/2009
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