MEDICARE: HALLSVILLE VOLUNTEER EMS

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	3416L0300X	Land Ambulance	102002	TX

General Provider Information

NPI Number	:	1326006412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALLSVILLE VOLUNTEER EMS

Provider Business Mailing Address
First Line	:	PO BOX 811
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-0811
Country	:	US
Telephone Number	:	903-668-3011
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 E MAIN ST
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-5243
Country	:	US
Telephone Number	:	903-668-3011
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	GARY SMITH
Credential	:
Telephone Number	:	903-668-3011

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	02/21/2008

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