Provider Demographics
NPI:1265480578
Name:RIVERSIDE EMS
Entity Type:Organization
Organization Name:RIVERSIDE EMS
Other - Org Name:RIVERSIDE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-583-6116
Mailing Address - Street 1:PO BOX 6530
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-6530
Mailing Address - Country:US
Mailing Address - Phone:956-583-6116
Mailing Address - Fax:956-583-6233
Practice Address - Street 1:116 N BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-0866
Practice Address - Country:US
Practice Address - Phone:956-583-6116
Practice Address - Fax:956-583-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800132341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport