Provider Demographics
NPI:1720274368
Name:PREMIUM CARE EMS LLC
Entity Type:Organization
Organization Name:PREMIUM CARE EMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-859-2567
Mailing Address - Street 1:6000 REIMS RD
Mailing Address - Street 2:STE# 3504
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3006
Mailing Address - Country:US
Mailing Address - Phone:832-859-2567
Mailing Address - Fax:888-253-1293
Practice Address - Street 1:6000 REIMS RD
Practice Address - Street 2:#3504
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3006
Practice Address - Country:US
Practice Address - Phone:832-859-2567
Practice Address - Fax:888-253-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10000523416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport