MEDICARE: EMS DIRECT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	1000077	TX
2	341600000X	Ambulance	1000077	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB686	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1003098047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMS DIRECT LLC

Provider Business Mailing Address
First Line	:	685 3RD AVE FL 9
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-4151
Country	:	US
Telephone Number	:	844-443-6246
Fax Number	:	833-907-2235

Provider Business Practice Location Address
First Line	:	1000 S 14TH ST # 1020
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-6422
Country	:	US
Telephone Number	:	347-903-5933
Fax Number	:	310-733-5689

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	ROBERT MBONYE
Credential	:
Telephone Number	:	585-278-0502

Provider Enumeration Date	:	12/01/2007
Last Update Date	:	02/11/2025

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Directions to “EMS DIRECT LLC ” Practice Location

Language	Start Address	Practice Location

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