Healthcare Provider Details
I. General information
NPI: 1750317483
Provider Name (Legal Business Name): PRIORITY CARE MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
165 EAST RAILROAD AVE
VIDOR TX
77662-4915
US
IV. Provider business mailing address
740 S ROCHESTER STE E
ONTARIO CA
91761-8179
US
V. Phone/Fax
- Phone: 800-600-3320
- Fax: 800-600-2502
- Phone: 800-600-2501
- Fax: 800-600-2502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | 800156 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
JAMES
NICHOLAS
KARRAS
Title or Position: EXECUTIVE VICE PRESIDENT & SECRETAR
Credential:
Phone: 800-600-2501