Provider Demographics
NPI:1922394238
Name:GRACE EMS INC
Entity Type:Organization
Organization Name:GRACE EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-876-4458
Mailing Address - Street 1:1801 N LAURENT ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5459
Mailing Address - Country:US
Mailing Address - Phone:713-876-4458
Mailing Address - Fax:281-817-5904
Practice Address - Street 1:1801 N LAURENT ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5459
Practice Address - Country:US
Practice Address - Phone:713-876-4458
Practice Address - Fax:281-817-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000651341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance