MEDICARE: AUBREY AREA AMBULANCE, 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	341600000X	Ambulance	61019	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	528203	OTHER		BC/BS OF TEXAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265447130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBREY AREA AMBULANCE, INC

Provider Business Mailing Address
First Line	:	200 W SYCAMORE ST
Second Line	:
City	:	AUBREY
State	:	TX
Zip	:	76227-4612
Country	:	US
Telephone Number	:	940-365-9785
Fax Number	:	940-365-9911

Provider Business Practice Location Address
First Line	:	200 W SYCAMORE ST
Second Line	:
City	:	AUBREY
State	:	TX
Zip	:	76227-4612
Country	:	US
Telephone Number	:	940-365-9785
Fax Number	:	940-365-9911

Authorized Official
Title or Position	:	EMS LT
Name	:	ROBERT MATTHEW LOLLAR
Credential	:
Telephone Number	:	940-365-9785

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	12/22/2017

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