Healthcare Provider Details

I. General information

NPI: 1932309606
Provider Name (Legal Business Name): CITY OF MARFA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 S HIGHLAND AVE
MARFA TX
79843
US

IV. Provider business mailing address

113 S HIGHLAND AVE PO BOX 787
MARFA TX
79843
US

V. Phone/Fax

Practice location:
  • Phone: 432-729-3151
  • Fax: 432-729-3158
Mailing address:
  • Phone: 432-729-3151
  • Fax: 432-729-3158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JESSIE DAVE PENA
Title or Position: EMS DIRECTOR
Credential:
Phone: 432-295-1212