Provider Demographics
NPI:1538474077
Name:SUNRISE AMBULANCE SERVICE
Entity Type:Organization
Organization Name:SUNRISE AMBULANCE SERVICE
Other - Org Name:STAR RISE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIEDOZIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:AGBOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-723-5269
Mailing Address - Street 1:PO BOX 710419
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-0419
Mailing Address - Country:US
Mailing Address - Phone:832-723-5269
Mailing Address - Fax:281-674-8120
Practice Address - Street 1:13526 LA CONCHA LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5125
Practice Address - Country:US
Practice Address - Phone:832-723-5269
Practice Address - Fax:281-674-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10004783416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport