Healthcare Provider Details

I. General information

NPI: 1326006412
Provider Name (Legal Business Name): HALLSVILLE VOLUNTEER EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E MAIN ST
HALLSVILLE TX
75650-5243
US

IV. Provider business mailing address

PO BOX 811
HALLSVILLE TX
75650-0811
US

V. Phone/Fax

Practice location:
  • Phone: 903-668-3011
  • Fax:
Mailing address:
  • Phone: 903-668-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number102002
License Number StateTX

VIII. Authorized Official

Name: GARY SMITH
Title or Position: DIRECTOR
Credential:
Phone: 903-668-3011