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General NPI Number Information
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NPI Number | 1679814453
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Entity Type | Organization
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Legal Business Name | MRW MEDICAL TRANSPORT, LLC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 3700 FREDERICKSBURG RD SUITE 117
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City | SAN ANTONIO
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State | TX
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Zip | 78201-3269
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Country | US
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Telephone | 210-226-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 898
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City | BUDA
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State | TX
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Zip | 78610-0898
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Country | US
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Telephone | 210-226-1111
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICAELA WOOTEN
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Credential |
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Telephone | 210-834-2559
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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 | 1000884
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License Number State | TX
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