=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396019196
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H&E HEALTH SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2012
-----------------------------------------------------
Last Update Date | 02/27/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13610 MIDWAY RD STE 260
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75244-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-385-7125
-----------------------------------------------------
Fax | 972-385-7875
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13610 MIDWAY RD STE 260
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75244-4347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-385-7125
-----------------------------------------------------
Fax | 972-385-7875
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | EVANS A OKOROAFOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-385-7125
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1000784
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------