MEDICARE: ADVANCE CARE 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	341600000X	Ambulance	1000440	TX

General Provider Information

NPI Number	:	1366760258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE CARE EMS INC

Provider Business Mailing Address
First Line	:	1710 S DAIRY ASHFORD ST
Second Line	:	SUITE 108
City	:	HOUSTON
State	:	TX
Zip	:	77077-3853
Country	:	US
Telephone Number	:	281-679-6840
Fax Number	:	281-679-6842

Provider Business Practice Location Address
First Line	:	1710 S DAIRY ASHFORD ST
Second Line	:	SUITE 108
City	:	HOUSTON
State	:	TX
Zip	:	77077-3853
Country	:	US
Telephone Number	:	281-679-6840
Fax Number	:	281-679-6842

Authorized Official
Title or Position	:	CEO
Name	:	AHMED BOMBATA
Credential	:
Telephone Number	:	281-679-6840

Provider Enumeration Date	:	05/17/2010
Last Update Date	:	09/23/2010

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