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General NPI Number Information
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NPI Number | 1720319502
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Entity Type | Organization
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Legal Business Name | PREMIUM EMERGENCY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 2210 CLAWSON FALLS LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-8973
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Country | US
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Telephone | 713-876-0477
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Fax | 281-239-7020
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Provider Business Mailing Address
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Address Line | 2210 CLAWSON FALLS LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-8973
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Country | US
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Telephone | 713-876-0477
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Fax | 281-239-7020
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL ODUCHE
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Credential |
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Telephone | 713-876-0477
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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 | 1000385
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License Number State | TX
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