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General NPI Number Information
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NPI Number | 1548418957
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Entity Type | Organization
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Legal Business Name | LIFESAVERS AMBULANCE GROUP, INC.
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 120 S MAIN ST STE 220
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City | VICTORIA
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State | TX
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Zip | 77901-8144
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Country | US
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Telephone | 713-922-0693
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Fax | 713-975-8245
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Provider Business Mailing Address
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Address Line | 120 S MAIN ST STE 220
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City | VICTORIA
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State | TX
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Zip | 77901-8144
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Country | US
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Telephone | 713-922-0693
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Fax | 713-975-8245
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SYLVESTER ARISE
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Credential |
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Telephone | 713-922-0693
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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 | 1000161
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License Number State | TX
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