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General NPI Number Information
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NPI Number | 1194945907
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Entity Type | Organization
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Legal Business Name | HASKELL COUNTY AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 1300 S 1ST ST
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City | HASKELL
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State | TX
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Zip | 79521-5428
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Country | US
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Telephone | 940-864-3945
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Fax | 940-864-2575
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | HASKELL
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State | TX
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Zip | 79521-0073
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Country | US
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Telephone | 940-864-3945
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Fax | 940-864-2575
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CASEY CALDWELL
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Credential | EMT-P
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Telephone | 940-864-3945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 104002
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License Number State | TX
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