Southern Star EMS Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1000647 Issued in TX

Legal business name

SOUTHERN STAR EMS INC

Practice address

650 Ih 10 S
Suite 12
Beaumont, TX 77707-4007

Phone

(409) 499-4787

NPI assigned

Jun 16, 2011

Last updated

Jul 19, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Enajite Omezi

Title

Owner

Phone

(409) 499-4787

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1801181946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 IH 10 S",
            "address_2": "SUITE 12",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777074007",
            "telephone_number": "409-499-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 IH 10 S",
            "address_2": "SUITE 12",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777074007",
            "telephone_number": "409-499-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN STAR EMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "OMEZI",
        "authorized_official_first_name": "ENAJITE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-499-4787"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "1000647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Beaumont, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.