Provider Demographics
NPI:1609921246
Name:ABSOLUTE AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:ABSOLUTE AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:GOODIN
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:979-848-8741
Mailing Address - Street 1:1216 N VELASCO ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-3078
Mailing Address - Country:US
Mailing Address - Phone:979-848-8741
Mailing Address - Fax:979-549-0770
Practice Address - Street 1:1216 N VELASCO ST
Practice Address - Street 2:SUITE F
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3078
Practice Address - Country:US
Practice Address - Phone:979-848-8741
Practice Address - Fax:979-549-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8002293416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport