Provider Demographics
NPI:1760604649
Name:VENTURA MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:VENTURA MEDICAL SERVICES, INC
Other - Org Name:VENTURA EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-228-3478
Mailing Address - Street 1:5907 THEALL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-2341
Mailing Address - Country:US
Mailing Address - Phone:936-228-3478
Mailing Address - Fax:936-755-1037
Practice Address - Street 1:130 MEDICAL CENTER PKWY STE 7
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4943
Practice Address - Country:US
Practice Address - Phone:936-228-3478
Practice Address - Fax:936-755-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197693801Medicaid