Provider Demographics
NPI:1942528567
Name:PHC AMBULANCE INC
Entity Type:Organization
Organization Name:PHC AMBULANCE INC
Other - Org Name:PRIME HEALTH CARE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONIFACE
Authorized Official - Middle Name:EMENIKE
Authorized Official - Last Name:IBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-677-3565
Mailing Address - Street 1:7447 HARWIN DR
Mailing Address - Street 2:170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2016
Mailing Address - Country:US
Mailing Address - Phone:832-677-3665
Mailing Address - Fax:
Practice Address - Street 1:7447 HARWIN DR
Practice Address - Street 2:170
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2016
Practice Address - Country:US
Practice Address - Phone:832-677-3665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB1029Medicare PIN