Provider Demographics
NPI:1952682387
Name:LIFE AID EMS INC
Entity Type:Organization
Organization Name:LIFE AID EMS INC
Other - Org Name:LIFE AID EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:EZIULOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-995-1168
Mailing Address - Street 1:7514 NORTHFORK HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2283
Mailing Address - Country:US
Mailing Address - Phone:281-995-1168
Mailing Address - Fax:
Practice Address - Street 1:7514 NORTHFORK HOLLOW LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2283
Practice Address - Country:US
Practice Address - Phone:281-995-1168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000670341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance