MEDICARE: ST THOMAS AMBULANCE 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	1000499	TX

General Provider Information

NPI Number	:	1598072134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST THOMAS AMBULANCE INC

Provider Business Mailing Address
First Line	:	8622 ELM LAKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5389
Country	:	US
Telephone Number	:	832-364-0214
Fax Number	:	281-565-9874

Provider Business Practice Location Address
First Line	:	8622 ELM LAKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5389
Country	:	US
Telephone Number	:	832-364-0214
Fax Number	:	281-565-9874

Authorized Official
Title or Position	:	CEO
Name	:	NOSA A AIG
Credential	:
Telephone Number	:	832-364-0214

Provider Enumeration Date	:	09/02/2010
Last Update Date	:	09/02/2010

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Directions to “ST THOMAS AMBULANCE INC ” Practice Location

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