1861495624 NPI number — CITY OF CLAUDE

Table of content: (NPI 1861495624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861495624 NPI number — CITY OF CLAUDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CLAUDE
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 CLAUDE VOLUNTEER AMBULANCE SERVICE
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:
1861495624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 231
Provider Second Line Business Mailing Address:
115 TRICE STREET
Provider Business Mailing Address City Name:
CLAUDE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79019-0231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-226-3261
Provider Business Mailing Address Fax Number:
806-226-7019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 PARKS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAUDE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79019-0231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-226-3261
Provider Business Practice Location Address Fax Number:
806-226-7019
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
IRENE
Authorized Official Title or Position:
CLAUDE CITY SECRETARY
Authorized Official Telephone Number:
806-226-3261

Provider Taxonomy Codes

  • Taxonomy code: 146L00000X , with the licence number:  006001 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: 006001 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 006001 , 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: "N" .

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

  • Identifier: 000003601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102964100 . This is a "AMBULANCE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: TX0000001 . This is a "AMBULANCE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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