Healthcare Provider Details

I. General information

NPI: 1407027493
Provider Name (Legal Business Name): TERRELL COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 EAST OAK ST.
SANDERSON TX
79848
US

IV. Provider business mailing address

PO BOX 116
SANDERSON TX
79848-0116
US

V. Phone/Fax

Practice location:
  • Phone: 432-345-2525
  • Fax: 432-345-2740
Mailing address:
  • Phone: 432-345-2727
  • Fax: 432-345-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number222001
License Number StateTX

VIII. Authorized Official

Name: MAGAN JOLYNN JOHNSON
Title or Position: EMS DIRECTOR
Credential:
Phone: 432-345-2727