MEDICARE: CRR ENTERPRISES, 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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AMB584	OTHER	TX	BLUE CROSS AND BLUE SHIEL

General Provider Information

NPI Number	:	1619972619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRR ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1336
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-0014
Country	:	US
Telephone Number	:	409-384-5570
Fax Number	:	409-755-6030

Provider Business Practice Location Address
First Line	:	615 E GIBSON ST
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-5105
Country	:	US
Telephone Number	:	409-384-5570
Fax Number	:	409-384-4042

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CLAUDETTE READ
Credential	:
Telephone Number	:	409-384-5570

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/22/2020

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Directions to “CRR ENTERPRISES, INC. ” Practice Location

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