Healthcare Provider Details

I. General information

NPI: 1053760041
Provider Name (Legal Business Name): HUTCHINSON COUNTY EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL DR
BORGER TX
79007-7579
US

IV. Provider business mailing address

100 MEDICAL DR
BORGER TX
79007-7579
US

V. Phone/Fax

Practice location:
  • Phone: 806-467-5700
  • Fax: 806-467-5704
Mailing address:
  • Phone: 806-467-5700
  • Fax: 806-467-5704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1000955
License Number StateTX

VIII. Authorized Official

Name: DINA KATHLEEN HERMES
Title or Position: TREASURER
Credential: CPA
Phone: 719-763-2272