1710981774 NPI number — METROPOLITAN AREA EMS AUTHORITY

Table of content: SARAH E MCFEGGAN (NPI 1053695528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710981774 NPI number — METROPOLITAN AREA EMS AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN AREA EMS AUTHORITY
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:
MEDSTAR MOBILE HEALTHCARE
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:
1710981774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 ALTA MERE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76116-4115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-923-3700
Provider Business Mailing Address Fax Number:
817-632-0537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 ALTA MERE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-923-3700
Provider Business Practice Location Address Fax Number:
817-632-0537
Provider Enumeration Date:
06/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SIMPSON
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
817-923-3700

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  220062 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 088220101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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