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General NPI Number Information
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NPI Number | 1851375695
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Entity Type | Organization
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Legal Business Name | STAT SERVICES OF JASPER COUNTY A, LLP
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2418 N WHEELER ST
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City | JASPER
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State | TX
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Zip | 75951-2115
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Country | US
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Telephone | 409-833-3834
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Fax | 409-833-2060
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Provider Business Mailing Address
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Address Line | PO BOX 552
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City | BEAUMONT
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State | TX
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Zip | 77704-0552
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Country | US
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Telephone | 409-833-3834
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Fax | 409-833-2060
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Authorized Official
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Title or Position | DIRECTOR BILLING - OFFICE MANAGER
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Name | KATE CARROLL
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Credential |
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Telephone | 409-833-3834
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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 | 121101
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License Number State | TX
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