Healthcare Provider Details

I. General information

NPI: 1467550707
Provider Name (Legal Business Name): B & M AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 N ORANGE STREET
GIDDINGS TX
78942
US

IV. Provider business mailing address

PO BOX 691363
HOUSTON TX
77269-1363
US

V. Phone/Fax

Practice location:
  • Phone: 979-542-6284
  • Fax: 979-542-2424
Mailing address:
  • Phone: 281-397-0397
  • Fax: 281-397-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number144001
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number144001
License Number StateTX

VIII. Authorized Official

Name: RODNEY MERSIOVSKY
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 979-542-8471