Provider Demographics
NPI:1093952863
Name:ABSOLUTE OF SA AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:ABSOLUTE OF SA AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-678-9111
Mailing Address - Street 1:1301 HOSPITAL BLVD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-2731
Mailing Address - Country:US
Mailing Address - Phone:210-678-9111
Mailing Address - Fax:830-393-8829
Practice Address - Street 1:1301 HOSPITAL BLVD
Practice Address - Street 2:UNIT 2
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-2731
Practice Address - Country:US
Practice Address - Phone:830-393-4271
Practice Address - Fax:830-393-8829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000213341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance