MEDICARE: AMBUHEALTH 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	332BC3200X	Customized Equipment (DME)	0040672	TX

General Provider Information

NPI Number	:	1578645636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBUHEALTH INC

Provider Business Mailing Address
First Line	:	6530 SUPPLY ROW
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4514
Country	:	US
Telephone Number	:	713-923-7222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6530 SUPPLY ROW
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-4514
Country	:	US
Telephone Number	:	713-923-7222
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JESSE MYERS
Credential	:	OWNER
Telephone Number	:	713-923-7222

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/22/2020

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