MEDICARE: HOUSTON HEALTHCARE COMPLEX EMS

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
2	3416L0300X	Land Ambulance

Other Identifiers

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

General Provider Information

NPI Number	:	1770539884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON HEALTHCARE COMPLEX EMS

Provider Business Mailing Address
First Line	:	1601 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3431
Country	:	US
Telephone Number	:	478-975-5400
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	:	478-975-5400
Fax Number	:	478-322-5102

Authorized Official
Title or Position	:	CHIEF FANANCIAL OFFI
Name	:	SEAN S WHILDEN
Credential	:
Telephone Number	:	478-542-7959

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/01/2013

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Directions to “HOUSTON HEALTHCARE COMPLEX EMS ” Practice Location

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