MEDICARE: CITY OF FORT STOCKTON

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
1	341600000X	Ambulance	186006	TX

General Provider Information

NPI Number	:	1083603757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF FORT STOCKTON

Provider Business Mailing Address
First Line	:	121 W 2ND ST
Second Line	:
City	:	FORT STOCKTON
State	:	TX
Zip	:	79735-6711
Country	:	US
Telephone Number	:	432-336-8525
Fax Number	:	432-336-6273

Provider Business Practice Location Address
First Line	:	121 W 2ND ST
Second Line	:
City	:	FORT STOCKTON
State	:	TX
Zip	:	79735-6711
Country	:	US
Telephone Number	:	432-336-8525
Fax Number	:	432-336-6273

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MRS. PENNY SMITH
Credential	:
Telephone Number	:	432-336-8525

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	08/22/2020

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Directions to “CITY OF FORT STOCKTON ” Practice Location

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