Provider Demographics
NPI:1114242344
Name:COMMIT CARE EMS LLC
Entity Type:Organization
Organization Name:COMMIT CARE EMS LLC
Other - Org Name:COMMIT CARE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AVERIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-704-4050
Mailing Address - Street 1:4625 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3106
Mailing Address - Country:US
Mailing Address - Phone:281-745-2426
Mailing Address - Fax:
Practice Address - Street 1:4625 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3106
Practice Address - Country:US
Practice Address - Phone:281-745-2426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000390341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB1017Medicare PIN