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General NPI Number Information
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NPI Number | 1952675613
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Entity Type | Organization
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Legal Business Name | PRIO-CARE
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 405 S WASHINGTON ST # 306
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-4636
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Country | US
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Telephone | 830-460-1000
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Fax | 830-997-8714
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Provider Business Mailing Address
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Address Line | 105 RIDGE VIEW DR
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City | BOERNE
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State | TX
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Zip | 78006-6414
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Country | US
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Telephone | 210-724-7217
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Fax | 830-997-8714
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Authorized Official
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Title or Position | COORDINATOR / PARTNER
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Name | MR. ADRIAN GLENN COOK
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Credential |
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Telephone | 830-385-5966
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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 | 1000771
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License Number State | TX
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