Provider Demographics
NPI:1376832907
Name:CHOICE AMBULANCE SERVICES,LLC
Entity Type:Organization
Organization Name:CHOICE AMBULANCE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-265-5753
Mailing Address - Street 1:P. O. BOX 112087
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016
Mailing Address - Country:US
Mailing Address - Phone:832-265-5753
Mailing Address - Fax:
Practice Address - Street 1:600 KENRICK DR.
Practice Address - Street 2:C-26
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3698
Practice Address - Country:US
Practice Address - Phone:832-265-5753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance