MEDICARE: CITY OF WILLS POINT EMS

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	234018	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	506924	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1184623613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF WILLS POINT EMS

Provider Business Mailing Address
First Line	:	PO BOX 505
Second Line	:
City	:	WILLS POINT
State	:	TX
Zip	:	75169-0505
Country	:	US
Telephone Number	:	903-873-2578
Fax Number	:	903-873-5512

Provider Business Practice Location Address
First Line	:	121 S 4TH ST
Second Line	:
City	:	WILLS POINT
State	:	TX
Zip	:	75169-2632
Country	:	US
Telephone Number	:	903-873-3011
Fax Number	:	903-873-5512

Authorized Official
Title or Position	:	CITY MANAGER
Name	:	MR. C.C. BUTCH GIRDLEY
Credential	:
Telephone Number	:	903-873-2578

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	10/24/2007

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Directions to “CITY OF WILLS POINT EMS ” Practice Location

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