Provider Demographics
NPI:1518151257
Name:AMED AMBULANCE INC
Entity Type:Organization
Organization Name:AMED AMBULANCE INC
Other - Org Name:AMED STAFFING INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALT
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-935-1234
Mailing Address - Street 1:8900 EMMETT F LOWRY EXPY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-9116
Mailing Address - Country:US
Mailing Address - Phone:409-935-7913
Mailing Address - Fax:409-935-7926
Practice Address - Street 1:9002 EMMETT F LOWRY EXPY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2105
Practice Address - Country:US
Practice Address - Phone:409-935-1234
Practice Address - Fax:409-935-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000055341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB713Medicare Oscar/Certification