Provider Demographics
NPI:1922006105
Name:ALAMO AREA AMBULANCE, LLC
Entity type:Organization
Organization Name:ALAMO AREA AMBULANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:
Authorized Official - Last Name:PEGUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-591-9960
Mailing Address - Street 1:PO BOX 291183
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-1783
Mailing Address - Country:US
Mailing Address - Phone:830-591-9960
Mailing Address - Fax:210-682-5913
Practice Address - Street 1:306 S. GETTY ST.
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5607
Practice Address - Country:US
Practice Address - Phone:830-591-9960
Practice Address - Fax:210-682-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144738501Medicaid
TX144738501Medicaid