Provider Demographics
NPI:1407000938
Name:JIREH EMS, LLC
Entity type:Organization
Organization Name:JIREH EMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-783-2405
Mailing Address - Street 1:120 N DOGWOOD STREET
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-0000
Mailing Address - Country:US
Mailing Address - Phone:956-783-2405
Mailing Address - Fax:956-783-2400
Practice Address - Street 1:921 S CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-783-2405
Practice Address - Fax:956-783-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001773416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport