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General NPI Number Information
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NPI Number | 1255448908
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Entity Type | Organization
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Legal Business Name | MEDCARE AMBULANCE INC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 3503 S WW WHITE RD
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City | SAN ANTONIO
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State | TX
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Zip | 78222-5017
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Country | US
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Telephone | 210-337-7772
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Fax | 210-337-9282
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Provider Business Mailing Address
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Address Line | PO BOX 625
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City | ADKINS
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State | TX
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Zip | 78101-0625
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Country | US
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Telephone | 210-337-7772
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Fax | 210-337-9282
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Authorized Official
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Title or Position | PRES
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Name | MITCHEL WADE SHANER
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Credential |
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Telephone | 210-337-7772
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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 | 015109
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License Number State | TX
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