Provider Demographics
NPI:1396756839
Name:J & S AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:J & S AMBULANCE SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EARLETTE
Authorized Official - Middle Name:YAWN
Authorized Official - Last Name:STOWE
Authorized Official - Suffix:
Authorized Official - Credentials:NREMTP
Authorized Official - Phone:409-283-3908
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:
Mailing Address - City:COLMESNEIL
Mailing Address - State:TX
Mailing Address - Zip Code:75938
Mailing Address - Country:US
Mailing Address - Phone:409-283-3908
Mailing Address - Fax:409-331-9919
Practice Address - Street 1:109 W LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-5225
Practice Address - Country:US
Practice Address - Phone:409-283-3908
Practice Address - Fax:409-331-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800079146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB487Medicare PIN
TXAMB487Medicare ID - Type UnspecifiedAMBULANCE