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General NPI Number Information
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NPI Number | 1821683160
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Entity Type | Organization
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Legal Business Name | EWA NON EMERGENCY MEDICAL TRANSPORT AND COURIER SERVICE LLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 7803 KINGS SPG
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City | SAN ANTONIO
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State | TX
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Zip | 78254-6068
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Country | US
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Telephone | 210-996-6370
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Fax |
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Provider Business Mailing Address
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Address Line | 7803 KINGS SPG
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City | SAN ANTONIO
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State | TX
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Zip | 78254-6068
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Country | US
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Telephone | 210-889-6973
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CLYDE GANTRY ROSE
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Credential |
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Telephone | 210-507-2522
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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