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General NPI Number Information
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NPI Number | 1720023278
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Entity Type | Organization
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Legal Business Name | ST MICHAEL EMS INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 22215 WOODROSE DR
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City | KATY
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State | TX
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Zip | 77450-2423
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Country | US
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Telephone | 832-816-5913
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Fax | 281-392-0558
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Provider Business Mailing Address
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Address Line | 22215 WOODROSE DR
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City | KATY
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State | TX
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Zip | 77450-2423
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Country | US
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Telephone | 832-816-5913
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Fax | 281-392-0558
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JEFFREY RYAN TOMBERLIN
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Credential | EMT
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Telephone | 832-816-5913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 800144
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License Number State | TX
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