=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730441684
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAMS EMS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2012
-----------------------------------------------------
Last Update Date | 06/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2715 DARBY BROOK DR
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77545-8122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-438-4389
-----------------------------------------------------
Fax | 281-809-5742
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2715 DARBY BROOK DR
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77545-8122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-438-4389
-----------------------------------------------------
Fax | 281-809-5742
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | OBIEFUNA M. MONWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-438-4389
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1000753
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------