Provider Demographics
NPI:1255731592
Name:ATLANTIS AMBULANCE SERVICE LLC
Entity type:Organization
Organization Name:ATLANTIS AMBULANCE SERVICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-209-9207
Mailing Address - Street 1:5645 HILLCROFT ST
Mailing Address - Street 2:SUITE 607
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2296
Mailing Address - Country:US
Mailing Address - Phone:281-995-4854
Mailing Address - Fax:
Practice Address - Street 1:5645 HILLCROFT ST
Practice Address - Street 2:SUITE 607
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2296
Practice Address - Country:US
Practice Address - Phone:281-995-4854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport