Provider Demographics
NPI:1467550707
Name:B & M AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:B & M AMBULANCE SERVICE INC
Other - Org Name:LEE COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERSIOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-542-8471
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:1212 N ORANGE STREET
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942
Practice Address - Country:US
Practice Address - Phone:979-542-6284
Practice Address - Fax:979-542-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX144001207PE0004X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000011901Medicaid
TX590445788OtherPALMETTO GBA RAILROAD MED
TX502548Medicare UPIN