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General NPI Number Information
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NPI Number | 1497773246
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Entity Type | Organization
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Legal Business Name | EMERALD AMBULANCE SERVICE LLC.
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3817 PARKDALE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2390
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Country | US
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Telephone | 210-694-4505
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Fax | 210-877-6004
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Provider Business Mailing Address
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Address Line | PO BOX 690193
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City | SAN ANTONIO
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State | TX
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Zip | 78269-0193
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Country | US
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Telephone | 210-694-4508
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Fax | 210-877-6004
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAYMOND SOTELO
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Credential | EMT PARAMEDIC
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Telephone | 210-694-4508
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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 | 015110
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License Number State | TX
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