Provider Demographics
NPI:1265670962
Name:EXTREME EMS, INC.
Entity Type:Organization
Organization Name:EXTREME EMS, INC.
Other - Org Name:EXTREME EMS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-979-6811
Mailing Address - Street 1:8230 S WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-4226
Mailing Address - Country:US
Mailing Address - Phone:281-979-6811
Mailing Address - Fax:832-518-3532
Practice Address - Street 1:8230 S WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77303-4226
Practice Address - Country:US
Practice Address - Phone:281-979-6811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance