Provider Demographics
NPI:1821021015
Name:AMBU-CARE EMS, LLC
Entity Type:Organization
Organization Name:AMBU-CARE EMS, LLC
Other - Org Name:AMBU-CARE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SERVICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-773-4343
Mailing Address - Street 1:10710 S SAM HOUSTON PKWY W
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3054
Mailing Address - Country:US
Mailing Address - Phone:713-773-4343
Mailing Address - Fax:713-773-4341
Practice Address - Street 1:10710 S SAM HOUSTON PKWY W
Practice Address - Street 2:SUITE 270
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3054
Practice Address - Country:US
Practice Address - Phone:713-773-4343
Practice Address - Fax:713-773-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166984801Medicaid
TX166984801Medicaid