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General NPI Number Information
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NPI Number | 1124299912
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Entity Type | Organization
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Legal Business Name | MART EMERGENCY MEDICAL SERVICES INC.
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 409 E TEXAS AVE
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City | MART
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State | TX
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Zip | 76664-1445
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Country | US
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Telephone | 254-876-3322
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Fax | 254-876-3332
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Provider Business Mailing Address
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Address Line | PO BOX 335
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City | MART
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State | TX
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Zip | 76664-0335
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Country | US
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Telephone | 254-876-3322
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Fax | 254-876-3332
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Authorized Official
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Title or Position | PRESIDENT
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Name | THERESA MILLER
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Credential | EMT
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Telephone | 254-876-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 15100
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License Number State | TX
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