=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497072458
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REGIONAL AMBULANCE SERVICE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2010
-----------------------------------------------------
Last Update Date | 02/16/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5917 N 23RD ST SUITE B
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-3935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-783-6704
-----------------------------------------------------
Fax | 956-783-6703
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5917 N 23RD ST SUITE B
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-3935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-783-6704
-----------------------------------------------------
Fax | 956-783-6703
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. VICENTE SOLANO JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-221-6528
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1000426
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------