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General NPI Number Information
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NPI Number | 1548275514
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Entity Type | Organization
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Legal Business Name | PECOS AMBULANCE SERVICE
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 324 S CEDAR ST
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City | PECOS
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State | TX
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Zip | 79772-3211
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Country | US
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Telephone | 432-940-5725
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Fax | 940-239-0312
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | PECOS
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State | TX
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Zip | 79772-0009
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Country | US
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Telephone | 732-940-5725
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Fax | 940-239-0312
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Authorized Official
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Title or Position | EMS ADMINISTRATOR
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Name | DENNIS THORP
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Credential |
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Telephone | 432-940-5725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 195001
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License Number State | TX
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