Healthcare Provider Details

I. General information

NPI: 1457334773
Provider Name (Legal Business Name): CITY OF PANHANDLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 7TH ST
PANHANDLE TX
79068
US

IV. Provider business mailing address

PO BOX 129
PANHANDLE TX
79068-0129
US

V. Phone/Fax

Practice location:
  • Phone: 806-537-3904
  • Fax:
Mailing address:
  • Phone: 806-576-3303
  • Fax: 888-972-3563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: LORI BAZE
Title or Position: EMS DIRECTOR
Credential:
Phone: 806-537-3904