Bronzestar Ambulance Service LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1000454 Issued in TX

Legal business name

BRONZESTAR AMBULANCE SERVICE LLC

Practice address

5816 East Drive Unit a
Bronzestar Ambulance Service LLC
Laredo, TX 78041-6851

Phone

(956) 712-3667

Fax

(956) 753-6013

NPI assigned

May 26, 2010

Last updated

Sep 12, 2024By 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

Mrs. Patricia Medina

Title

Chief Executive Office/Administrato

Phone

(956) 712-3667

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1932428257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 451750",
            "address_2": "BRONZESTAR AMBULANCE LLC",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780450043",
            "telephone_number": "956-712-3667",
            "fax_number": "956-753-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 EAST DRIVE UNIT A",
            "address_2": "BRONZESTAR AMBULANCE SERVICE LLC",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416851",
            "telephone_number": "956-712-3667",
            "fax_number": "956-753-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONZESTAR AMBULANCE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICE/ADMINISTRATO",
        "authorized_official_telephone_number": "956-712-3667",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "1000454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TPIBASE#2185134",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Laredo, TX
• Providers in Laredo, TX by specialty
• Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.