Provider Demographics
NPI:1740561828
Name:BELLEMO AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:BELLEMO AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBROISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-545-1867
Mailing Address - Street 1:PO BOX 441353
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77244-1353
Mailing Address - Country:US
Mailing Address - Phone:832-545-1867
Mailing Address - Fax:713-588-1827
Practice Address - Street 1:9896 BISSONNET ST
Practice Address - Street 2:SUITE 430
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8162
Practice Address - Country:US
Practice Address - Phone:832-545-1867
Practice Address - Fax:713-588-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006923416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport