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NPI Code Detail

MEDICARE: YORKTOWN EMERGENCY MEDICAL SERVICE

MEDICARE: YORKTOWN EMERGENCY MEDICAL SERVICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance062008TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1514705OTHERTXBCBS PROVIDER NUMBER
2062008OTHERTXTDH LICENSE NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063415107
Entity Type Code : Organization
Provider Name (Legal Business Name) : YORKTOWN EMERGENCY MEDICAL SERVICE
Provider Business Mailing Address
First Line : PO BOX 142
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-0142
Country : US
Telephone Number : 361-564-9410
Fax Number : 361-564-9476
Provider Business Practice Location Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9410
Fax Number : 361-564-9476
Authorized Official
Title or Position : AOR
Name : JOHN WILLIAM GREEN
Credential :
Telephone Number : 361-938-7080
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/27/2018

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Directions to “YORKTOWN EMERGENCY MEDICAL SERVICE ” Practice Location

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