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General NPI Number Information
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NPI Number | 1164607941
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Entity Type | Organization
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Legal Business Name | AMERISTARR AMBULANCE L.L.C.
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Dates
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Enumeration Date | 12/30/2007
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 102 E 2ND ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3802
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Country | US
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Telephone | 956-487-8800
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Fax | 956-487-8810
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Provider Business Mailing Address
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Address Line | PO BOX 118
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-0118
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Country | US
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Telephone | 956-487-8800
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Fax | 956-487-8810
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. HUMBERTO TREVINO
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Credential | EMT-I
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Telephone | 956-844-8109
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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 | 1000092
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License Number State | TX
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