1609897073 NPI number — COVE EMERGENCY SERVICES INC

Table of content: (NPI 1609897073)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609897073 NPI number — COVE EMERGENCY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COVE EMERGENCY SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COVE EMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609897073
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1590
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONT BELVIEU
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77580-1590
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-573-9193
Provider Business Mailing Address Fax Number:
281-573-3385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5735 FM 565 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAYTOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-573-9193
Provider Business Practice Location Address Fax Number:
281-573-3385
Provider Enumeration Date:
07/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOLLAWAY
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
281-573-9193

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  36010 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AMB729 . This is a "BC/BS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".