MEDICARE: HOUSTON HEALTHCARE EMS INC

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	076-01	GA

General Provider Information

NPI Number	:	1407294028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HEALTHCARE EMS INC

Provider Business Mailing Address
First Line	:	PO BOX 100086
Second Line	:	BOX 1086
City	:	ATLANTA
State	:	GA
Zip	:	30348-0086
Country	:	US
Telephone Number	:	478-542-7959
Fax Number	:	478-322-5102

Provider Business Practice Location Address
First Line	:	1553 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3449
Country	:	US
Telephone Number	:	478-542-7959
Fax Number	:	478-322-5102

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	MELISS PHAGAN
Credential	:
Telephone Number	:	478-542-7756

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	10/08/2025

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