MEDICARE: NORTH BLANCO COUNTY EMERGENCY MEDICAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	016002	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023086063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BLANCO COUNTY EMERGENCY MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 557
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636-0557
Country	:	US
Telephone Number	:	830-868-7834
Fax Number	:	830-868-9234

Provider Business Practice Location Address
First Line	:	105 BILL WATSON DRIVE
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636-0557
Country	:	US
Telephone Number	:	830-868-7834
Fax Number	:	830-868-9234

Authorized Official
Title or Position	:	EMS CHIEF
Name	:	BENJAMIN J OAKLEY
Credential	:	MPA, LP
Telephone Number	:	830-868-7834

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/27/2020

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