Provider Demographics
NPI:1164438750
Name:QUALITY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:QUALITY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:830-569-6669
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-0872
Mailing Address - Country:US
Mailing Address - Phone:830-569-6669
Mailing Address - Fax:830-569-3872
Practice Address - Street 1:619 2ND ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-3101
Practice Address - Country:US
Practice Address - Phone:830-569-6666
Practice Address - Fax:830-569-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000255201Medicaid
TX509366Medicare PIN