MEDICARE: FIRST CLASS AMBULANCE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance

General Provider Information

NPI Number	:	1164675856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CLASS AMBULANCE SERVICES

Provider Business Mailing Address
First Line	:	620 E FREMONT ST APT 4
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78040-3977
Country	:	US
Telephone Number	:	956-220-9842
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 E FREMONT ST APT 4
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78040-3977
Country	:	US
Telephone Number	:	956-220-9842
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. BRENDA ELVIRA PENA
Credential	:
Telephone Number	:	956-220-9842

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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Directions to “FIRST CLASS AMBULANCE SERVICES ” Practice Location

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