MEDICARE: PRIDE 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	101266	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590012460	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396702361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIDE EMS LLC

Provider Business Mailing Address
First Line	:	PO BOX 924205
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77292-4205
Country	:	US
Telephone Number	:	713-641-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	6010 MILWEE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-6216
Country	:	US
Telephone Number	:	713-641-1111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT K SARLAY
Credential	:
Telephone Number	:	713-641-1111

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	03/07/2012

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Directions to “PRIDE EMS LLC ” Practice Location

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