MEDICARE: PRIME MED EMS INC

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	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164745105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME MED EMS INC

Provider Business Mailing Address
First Line	:	7322 SW FWY
Second Line	:	SUITE 2000
City	:	HOUSTON
State	:	TX
Zip	:	77074-2010
Country	:	US
Telephone Number	:	832-888-2469
Fax Number	:	713-981-4133

Provider Business Practice Location Address
First Line	:	5628 STAR LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7112
Country	:	US
Telephone Number	:	832-888-2469
Fax Number	:	713-981-4133

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. EULALIE TUNGU
Credential	:
Telephone Number	:	281-392-1482

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	11/15/2010

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Directions to “PRIME MED EMS INC ” Practice Location

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