Provider Demographics
NPI:1225392384
Name:MERCURY EMS LLC
Entity Type:Organization
Organization Name:MERCURY EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JARRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-241-4303
Mailing Address - Street 1:2737 RAND MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-1507
Mailing Address - Country:US
Mailing Address - Phone:361-241-4303
Mailing Address - Fax:361-241-6450
Practice Address - Street 1:2737 RAND MORGAN RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-1507
Practice Address - Country:US
Practice Address - Phone:361-241-4303
Practice Address - Fax:361-241-6450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAVENCORP INTERNATIONAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3002753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport