Provider Demographics
NPI:1952607459
Name:PATRIOT MEDICAL TRANSPORT
Entity type:Organization
Organization Name:PATRIOT MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-682-5300
Mailing Address - Street 1:310 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-7305
Mailing Address - Country:US
Mailing Address - Phone:888-380-5524
Mailing Address - Fax:
Practice Address - Street 1:310 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-7305
Practice Address - Country:US
Practice Address - Phone:888-380-5524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport