Provider Demographics
NPI:1972887545
Name:LATOM EMS INC
Entity Type:Organization
Organization Name:LATOM EMS INC
Other - Org Name:LATOM EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:OMOLARA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DARAMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-338-9637
Mailing Address - Street 1:12808 W AIRPORT BLVD STE 348
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6191
Mailing Address - Country:US
Mailing Address - Phone:832-338-9637
Mailing Address - Fax:
Practice Address - Street 1:12808 W AIRPORT BLVD STE 348
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6191
Practice Address - Country:US
Practice Address - Phone:832-338-9637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LATOM EMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-30
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10004713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport