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General NPI Number Information
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NPI Number | 1922392406
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Entity Type | Organization
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Legal Business Name | INTERCITY AMBULANCE FOR EMERGENCY MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5702 BOGART DR
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City | EDINBURG
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State | TX
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Zip | 78542-1558
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Country | US
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Telephone | 956-407-7744
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Fax |
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Provider Business Mailing Address
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Address Line | 5702 BOGART DR
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City | EDINBURG
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State | TX
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Zip | 78542-1558
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Country | US
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Telephone | 956-407-7744
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. SALVADOR A ROBLES
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Credential | PRESIDENT
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Telephone | 956-407-7744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1000631
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License Number State | TX
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