Provider Demographics
NPI:1598800625
Name:AMERICANA AMBULANCE, INC
Entity Type:Organization
Organization Name:AMERICANA AMBULANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:D
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-590-1911
Mailing Address - Street 1:PO BOX 17749
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-0749
Mailing Address - Country:US
Mailing Address - Phone:210-590-1911
Mailing Address - Fax:510-590-1924
Practice Address - Street 1:4127 E. SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3761
Practice Address - Country:US
Practice Address - Phone:210-590-1911
Practice Address - Fax:210-590-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0150913416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000725401Medicaid
TXAMB079Medicare ID - Type UnspecifiedPROVIDER NUMBER