Provider Demographics
NPI:1164745105
Name:PRIME MED EMS INC
Entity Type:Organization
Organization Name:PRIME MED EMS INC
Other - Org Name:PRIME MED EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EULALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-392-1482
Mailing Address - Street 1:7322 SW FWY
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2010
Mailing Address - Country:US
Mailing Address - Phone:832-888-2469
Mailing Address - Fax:713-981-4133
Practice Address - Street 1:5628 STAR LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7112
Practice Address - Country:US
Practice Address - Phone:832-888-2469
Practice Address - Fax:713-981-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214918901Medicaid
AMB987Medicare PIN