Provider Demographics
NPI:1720023278
Name:ST MICHAEL EMS INC
Entity Type:Organization
Organization Name:ST MICHAEL EMS INC
Other - Org Name:AMBULANCE PROVIDER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:TOMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:832-816-5913
Mailing Address - Street 1:22215 WOODROSE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2423
Mailing Address - Country:US
Mailing Address - Phone:832-816-5913
Mailing Address - Fax:281-392-0558
Practice Address - Street 1:22215 WOODROSE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2423
Practice Address - Country:US
Practice Address - Phone:832-816-5913
Practice Address - Fax:281-392-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800144341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance