MEDICARE: MAJESTIC 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	167003	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB705	OTHER	TX	BCBS TEXAS

General Provider Information

NPI Number	:	1346244928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJESTIC EMERGENCY MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 188
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-0188
Country	:	US
Telephone Number	:	800-617-1213
Fax Number	:	800-617-1214

Provider Business Practice Location Address
First Line	:	1414 HUTCHINS ST
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-2419
Country	:	US
Telephone Number	:	800-617-1213
Fax Number	:	800-617-1214

Authorized Official
Title or Position	:	OWNER
Name	:	JEFF GILBERT
Credential	:	PARAMEDIC
Telephone Number	:	800-617-1213

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/22/2020

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