MEDICARE: AMI-ADVANCED MEDIC 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	101281	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB637	OTHER	TX	BCBS PROVIDER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871583104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMI-ADVANCED MEDIC INC.

Provider Business Mailing Address
First Line	:	PO BOX 7761
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77387-7761
Country	:	US
Telephone Number	:	713-734-9760
Fax Number	:	713-734-9754

Provider Business Practice Location Address
First Line	:	1119 OAK CREEK DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-4926
Country	:	US
Telephone Number	:	713-734-9760
Fax Number	:	713-734-9754

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEX YEVERINO
Credential	:
Telephone Number	:	713-734-9760

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/22/2011

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