1831113596 NPI number — CITY OF FERRIS EMS

Table of content: (NPI 1831113596)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831113596 NPI number — CITY OF FERRIS EMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF FERRIS EMS
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:
CITY OF FERRIS 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:
1831113596
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 TOWN PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FERRIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75125-2537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-842-2898
Provider Business Mailing Address Fax Number:
972-544-3625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
203 S CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FERRIS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75125-2520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-842-2898
Provider Business Practice Location Address Fax Number:
972-544-3625
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DURAN
Authorized Official First Name:
EDDIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS ADMINISTRATOR
Authorized Official Telephone Number:
972-842-2898

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  70008 , 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: 505829 . This is a "BC/BS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00087901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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