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General NPI Number Information
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NPI Number | 1548439748
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Entity Type | Organization
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Legal Business Name | ITC MEDICAL TRANSPORT COMPANY, INC.
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 4325 KOSTORYZ RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78415-5018
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Country | US
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Telephone | 361-334-5870
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Fax | 361-334-5871
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Provider Business Mailing Address
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Address Line | PO BOX 7619
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City | CORPUS CHRISTI
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State | TX
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Zip | 78467-7619
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Country | US
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Telephone | 361-334-5870
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Fax | 361-334-5871
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Authorized Official
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Title or Position | MANAGER
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Name | PAULINE LEDESMA
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Credential |
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Telephone | 361-334-5870
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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 | 1000109
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License Number State | TX
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