Provider Demographics
NPI:1215200704
Name:KLEENEX EMS, INC
Entity Type:Organization
Organization Name:KLEENEX EMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GBENGA
Authorized Official - Last Name:AKAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-860-4576
Mailing Address - Street 1:5925 PHELAN BLVD # I
Mailing Address - Street 2:SUITE 175
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6253
Mailing Address - Country:US
Mailing Address - Phone:409-860-4576
Mailing Address - Fax:832-350-7894
Practice Address - Street 1:5925 PHELAN BLVD # I
Practice Address - Street 2:SUITE 175
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6253
Practice Address - Country:US
Practice Address - Phone:409-860-4576
Practice Address - Fax:832-350-7894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10007363416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000736OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES