MEDICARE: MED-TECH AMBULANCE

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	341600000X	Ambulance	068005	TX

General Provider Information

NPI Number	:	1881646206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-TECH AMBULANCE

Provider Business Mailing Address
First Line	:	4301 BRAZOS AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79764-3937
Country	:	US
Telephone Number	:	432-580-5262
Fax Number	:	432-550-8943

Provider Business Practice Location Address
First Line	:	4301 BRAZOS AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79764-3937
Country	:	US
Telephone Number	:	432-580-5262
Fax Number	:	432-550-8943

Authorized Official
Title or Position	:	OWNER DIRECTOR
Name	:	MELISSA A ROGERS
Credential	:
Telephone Number	:	432-580-5262

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/03/2008

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Directions to “MED-TECH AMBULANCE ” Practice Location

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