=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366778490
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GLO EMS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2009
-----------------------------------------------------
Last Update Date | 10/24/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2427 TEXANA WAY
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77406-9205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-573-6736
-----------------------------------------------------
Fax | 281-344-0001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2427 TEXANA WAY
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77406-9205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-573-6736
-----------------------------------------------------
Fax | 281-344-0001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. ESE OGHENE DAMIJO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-573-6736
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 1000336
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------