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General NPI Number Information
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NPI Number | 1730476482
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Entity Type | Organization
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Legal Business Name | MEDLINE EMS LLC
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 4542 LONG CREEK DR
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City | FRESNO
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State | TX
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Zip | 77545-6064
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Country | US
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Telephone | 281-972-2038
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Fax | 281-781-2555
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Provider Business Mailing Address
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Address Line | 9119 HIGHWAY 6 SUITE 230-240
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City | MISSOURI CITY
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State | TX
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Zip | 77459-4876
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Country | US
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Telephone | 281-972-2038
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Fax | 281-781-2555
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Authorized Official
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Title or Position | OWNER
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Name | NDUKA K UKAH
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Credential |
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Telephone | 281-972-2038
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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 | 1000652
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License Number State | TX
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