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NPI Code Detail

MEDICARE: PRECEDENCE AMBULANCE SERVICES LLC

MEDICARE: PRECEDENCE AMBULANCE SERVICES 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
13416L0300XLand Ambulance1000473TX

General Provider Information

NPI Number : 1790098945
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRECEDENCE AMBULANCE SERVICES LLC
Provider Business Mailing Address
First Line : 4010 HAWTHORNE GLEN CT
Second Line :
City : FRESNO
State : TX
Zip : 77545-8862
Country : US
Telephone Number : 832-297-6406
Fax Number : 281-972-9594
Provider Business Practice Location Address
First Line : 4010 HAWTHORNE GLEN CT
Second Line :
City : FRESNO
State : TX
Zip : 77545-8862
Country : US
Telephone Number : 832-297-6406
Fax Number : 281-972-9594
Authorized Official
Title or Position : DIRECTOR
Name : GREGORY TYRONE CUNNINGHAM
Credential :
Telephone Number : 832-297-6406
Provider Enumeration Date : 07/16/2010
Last Update Date : 07/16/2010

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Directions to “PRECEDENCE AMBULANCE SERVICES LLC ” Practice Location

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