MEDICARE: MEDICAL RESCUE 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	1000263	TX

General Provider Information

NPI Number	:	1821226838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL RESCUE EMS INC

Provider Business Mailing Address
First Line	:	11100 LOUETTA RD
Second Line	:	# 836
City	:	HOUSTON
State	:	TX
Zip	:	77070-1432
Country	:	US
Telephone Number	:	832-545-9577
Fax Number	:	713-344-1359

Provider Business Practice Location Address
First Line	:	11100 LOUETTA RD
Second Line	:	# 836
City	:	HOUSTON
State	:	TX
Zip	:	77070-1432
Country	:	US
Telephone Number	:	832-545-9577
Fax Number	:	713-344-1359

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MOHAMMAD SALLAQ
Credential	:
Telephone Number	:	832-545-9577

Provider Enumeration Date	:	06/29/2009
Last Update Date	:	06/29/2009

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