Provider Demographics
NPI:1962710004
Name:CLASSIC EMERGENCY MEDICAL SERVICES INC
Entity type:Organization
Organization Name:CLASSIC EMERGENCY MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOORE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-222-3986
Mailing Address - Street 1:2111 SPUR CANYON CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7251
Mailing Address - Country:US
Mailing Address - Phone:281-222-3986
Mailing Address - Fax:832-222-0002
Practice Address - Street 1:2111 SPUR CANYON CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-7251
Practice Address - Country:US
Practice Address - Phone:281-222-3986
Practice Address - Fax:832-222-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000490341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance