MEDICARE: SAFE RESPONSE MEDICAL TRANSPORTATION 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	1000375	TX

General Provider Information

NPI Number	:	1215267398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE RESPONSE MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	11214 FREESTONE AVE
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5518
Country	:	US
Telephone Number	:	832-206-8454
Fax Number	:

Provider Business Practice Location Address
First Line	:	3116 TELGE ST
Second Line	:	SUITE D
City	:	HOUSTON
State	:	TX
Zip	:	77054-2224
Country	:	US
Telephone Number	:	832-206-8454
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TONYA BROWN
Credential	:
Telephone Number	:	832-206-8454

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	06/18/2010

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