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General NPI Number Information
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NPI Number | 1730127325
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Entity Type | Organization
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Legal Business Name | RELIABLE AMBULANCE SERVICE OF LAREDO INC.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 1820 MARCELLA AVE
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City | LAREDO
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State | TX
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Zip | 78040-3957
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Country | US
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Telephone | 956-725-4461
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Fax | 956-728-0112
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Provider Business Mailing Address
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Address Line | PO BOX 440152
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City | LAREDO
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State | TX
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Zip | 78044-0152
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Country | US
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Telephone | 956-725-4461
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Fax | 956-728-0112
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FERNANDO CANSECO
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Credential |
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Telephone | 361-887-0262
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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 | 178034
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License Number State | TX
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