Provider Demographics
NPI:1164731808
Name:PENINSULA EMERGENCY MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:PENINSULA EMERGENCY MEDICAL SERVICES, INC.
Other - Org Name:PEMSI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-397-0397
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:2041 7TH STREET
Practice Address - Street 2:
Practice Address - City:HIGH ISLAND
Practice Address - State:TX
Practice Address - Zip Code:77623
Practice Address - Country:US
Practice Address - Phone:409-286-5811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000760OtherTDH LICENSE #
TX1000760OtherTDH LICENSE #