MEDICARE: ASTRO AMBULANCE MEDICAL 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
1	146N00000X	Basic Emergency Medical Technician	1000377	TX
2	343900000X	Non-emergency Medical Transport (VAN)	1000377	TX
3	3416L0300X	Land Ambulance	1000377	TX

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	:	1881916567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRO AMBULANCE MEDICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	5645 HILLCROFT ST
Second Line	:	# 607
City	:	HOUSTON
State	:	TX
Zip	:	77036-2296
Country	:	US
Telephone Number	:	281-866-1770
Fax Number	:	281-888-5077

Provider Business Practice Location Address
First Line	:	5645 HILLCROFT ST
Second Line	:	# 607
City	:	HOUSTON
State	:	TX
Zip	:	77036-2289
Country	:	US
Telephone Number	:	281-866-1770
Fax Number	:	281-888-5077

Authorized Official
Title or Position	:	INTITIAL REGISTERED AGENT
Name	:	MR. JAMES CHANEY
Credential	:
Telephone Number	:	281-866-1770

Provider Enumeration Date	:	02/22/2010
Last Update Date	:	09/30/2013

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