Provider Demographics
NPI:1710272729
Name:BROADWAY EMS INC
Entity Type:Organization
Organization Name:BROADWAY EMS INC
Other - Org Name:BROADWAY WESTSIDE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:IROH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-232-9099
Mailing Address - Street 1:127 BIG THICKET DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6193
Mailing Address - Country:US
Mailing Address - Phone:281-232-9099
Mailing Address - Fax:281-576-7438
Practice Address - Street 1:127 BIG THICKET DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6193
Practice Address - Country:US
Practice Address - Phone:281-232-9099
Practice Address - Fax:281-576-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006413416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport