=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275527947
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METRO AMBULANCE, LP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2005
-----------------------------------------------------
Last Update Date | 06/16/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 COMMERCIAL PL.,
-----------------------------------------------------
City | SCHERTZ
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-288-2788
-----------------------------------------------------
Fax | 210-566-1330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 COMMERCIAL PL.,
-----------------------------------------------------
City | SCHERTZ
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-288-2788
-----------------------------------------------------
Fax | 210-566-1330
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MRS. SUSAN BECK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-288-2788
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 094019
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------