1689713729 NPI number — WEST VOLUNTARY AMBULANCE ASSOCIATION

Table of content: (NPI 1689713729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689713729 NPI number — WEST VOLUNTARY AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST VOLUNTARY AMBULANCE ASSOCIATION
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:
Provider Other Organization Name Type Code:
6
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:
1689713729
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 MEADOW DR
Provider Second Line Business Mailing Address:
P.O. BOX 461
Provider Business Mailing Address City Name:
WEST
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76691-1033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-826-3779
Provider Business Mailing Address Fax Number:
254-826-3149

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 MEADOW DR
Provider Second Line Business Practice Location Address:
BOX 461
Provider Business Practice Location Address City Name:
WEST
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76691-1033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-826-3779
Provider Business Practice Location Address Fax Number:
254-826-3149
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MAREK
Authorized Official First Name:
TOM
Authorized Official Middle Name:
EDWIN
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
254-826-3779

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  300039 , 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)





Copyright © 2007-2025 www.npivalidator.com