Healthcare Provider Details
I. General information
NPI: 1407960180
Provider Name (Legal Business Name): CITIZENS EMERGENCY MEDICAL SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
911 S 1ST ST W UNIT A
CLYDE TX
79510-4035
US
IV. Provider business mailing address
PO BOX 1556
CLYDE TX
79510-1556
US
V. Phone/Fax
- Phone: 325-893-5754
- Fax: 325-893-4127
- Phone: 325-893-5754
- Fax: 325-893-4127
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | 030001 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
VICTOR
EUGENE
HUDMAN
II
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 325-893-1074