MEDICARE: PRESTON VOLUNTEER EMERGENCY SERVICE, 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	91007	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590013818	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB536	OTHER	TX	BC/BS OF TEXAS
2	AMB536	OTHER	TX	BC/BS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295755106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTON VOLUNTEER EMERGENCY SERVICE, INC

Provider Business Mailing Address
First Line	:	14691 HIGHWAY 120 N
Second Line	:
City	:	POTTSBORO
State	:	TX
Zip	:	75076-3348
Country	:	US
Telephone Number	:	903-786-3010
Fax Number	:	903-786-9889

Provider Business Practice Location Address
First Line	:	14691 HIGHWAY 120 N
Second Line	:
City	:	POTTSBORO
State	:	TX
Zip	:	75076-3348
Country	:	US
Telephone Number	:	903-786-3010
Fax Number	:	903-786-9889

Authorized Official
Title or Position	:	EMS DIRECTOR
Name	:	ALVIN CARROLL SHIELDS JR.
Credential	:
Telephone Number	:	903-786-3010

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	06/04/2012

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Directions to “PRESTON VOLUNTEER EMERGENCY SERVICE, INC ” Practice Location

Language	Start Address	Practice Location

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