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General NPI Number Information
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NPI Number | 1609921246
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Entity Type | Organization
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Legal Business Name | ABSOLUTE AMBULANCE SERVICE LLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 1216 N VELASCO ST SUITE F
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City | ANGLETON
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State | TX
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Zip | 77515-3078
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Country | US
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Telephone | 979-848-8741
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Fax | 979-549-0770
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Provider Business Mailing Address
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Address Line | 1216 N VELASCO ST SUITE F
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City | ANGLETON
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State | TX
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Zip | 77515-3078
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Country | US
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Telephone | 979-848-8741
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Fax | 979-549-0770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHARI DEANN GOODIN
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Credential | EMTP
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Telephone | 979-848-8741
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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 | 800229
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License Number State | TX
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