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General NPI Number Information
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NPI Number | 1093952863
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Entity Type | Organization
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Legal Business Name | ABSOLUTE OF SA AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 1301 HOSPITAL BLVD UNIT 2
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City | FLORESVILLE
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State | TX
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Zip | 78114-2731
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Country | US
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Telephone | 830-393-4271
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Fax | 830-393-8829
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Provider Business Mailing Address
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Address Line | 1301 HOSPITAL BLVD UNIT 2
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City | FLORESVILLE
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State | TX
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Zip | 78114-2731
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Country | US
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Telephone | 210-678-9111
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Fax | 830-393-8829
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JESSIE J DAVIS
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Credential |
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Telephone | 210-678-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1000213
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License Number State | TX
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