Provider Demographics
NPI:1881687598
Name:PHOENIX EMS WEST, INC.
Entity Type:Organization
Organization Name:PHOENIX EMS WEST, INC.
Other - Org Name:PHOENIX EMS WEST, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROJECT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-392-4251
Mailing Address - Street 1:761 CAROLINA ST
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8252
Mailing Address - Country:US
Mailing Address - Phone:281-392-4251
Mailing Address - Fax:281-392-8177
Practice Address - Street 1:761 CAROLINA ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8252
Practice Address - Country:US
Practice Address - Phone:281-392-4251
Practice Address - Fax:281-392-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX045003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045003OtherTX DEPT. OF HEALTH PROVID
TX045003OtherTX DEPT. OF HEALTH PROVID
TX=========Medicare UPIN