MEDICARE: J & F DESTINY EMS 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	1000690	TX

General Provider Information

NPI Number	:	1194007609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J & F DESTINY EMS LLC

Provider Business Mailing Address
First Line	:	6430 RICHMOND AVE
Second Line	:	SUITE 250-16
City	:	HOUSTON
State	:	TX
Zip	:	77057-5918
Country	:	US
Telephone Number	:	832-288-6886
Fax Number	:

Provider Business Practice Location Address
First Line	:	6430 RICHMOND AVE
Second Line	:	SUITE 250-16
City	:	HOUSTON
State	:	TX
Zip	:	77057-5918
Country	:	US
Telephone Number	:	832-288-6886
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEANNE WILLIAMS
Credential	:
Telephone Number	:	832-288-6886

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	10/04/2011

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Directions to “J & F DESTINY EMS LLC ” Practice Location

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