Healthcare Provider Details

I. General information

NPI: 1043300403
Provider Name (Legal Business Name): WASKOM VOLUNTEER FIRE DEPARTMENT AND EMS SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 EAST TEXAS AVE
WASKOM TX
75692-1757
US

IV. Provider business mailing address

PO BOX 1757
WASKOM TX
75692-1757
US

V. Phone/Fax

Practice location:
  • Phone: 888-473-0920
  • Fax: 832-778-5040
Mailing address:
  • Phone: 903-473-0927
  • Fax: 877-687-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number000000
License Number StateTX

VIII. Authorized Official

Name: MASCHA TAYLOR
Title or Position: MANAGER
Credential: BILLING SPECIALIST
Phone: 903-473-0927