Provider Demographics
NPI:1376576553
Name:REDDS AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:REDDS AMBULANCE SERVICE INC
Other - Org Name:REDD'S AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SERVICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-855-6311
Mailing Address - Street 1:PO BOX 23120
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77720-3120
Mailing Address - Country:US
Mailing Address - Phone:409-899-2644
Mailing Address - Fax:409-899-2645
Practice Address - Street 1:5655 EASTEX FWY
Practice Address - Street 2:SUITE M-6A
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6923
Practice Address - Country:US
Practice Address - Phone:409-899-2644
Practice Address - Fax:409-899-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8001583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186922401Medicaid
TX800158OtherAMBULANCE LICENSE NUMBER
AMB537Medicare PIN