Provider Demographics
NPI:1730476482
Name:MEDLINE EMS LLC
Entity Type:Organization
Organization Name:MEDLINE EMS LLC
Other - Org Name:MEDLINE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NDUKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:UKAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-972-2038
Mailing Address - Street 1:9119 HIGHWAY 6
Mailing Address - Street 2:SUITE 230-240
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4876
Mailing Address - Country:US
Mailing Address - Phone:281-972-2038
Mailing Address - Fax:281-781-2555
Practice Address - Street 1:4542 LONG CREEK DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-6064
Practice Address - Country:US
Practice Address - Phone:281-972-2038
Practice Address - Fax:281-781-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006523416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport