Provider Demographics
NPI:1003830662
Name:CITY OF KRUM
Entity Type:Organization
Organization Name:CITY OF KRUM
Other - Org Name:KRUM FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-482-6257
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-0333
Mailing Address - Country:US
Mailing Address - Phone:940-482-6257
Mailing Address - Fax:940-482-3705
Practice Address - Street 1:333 W. LAKE ST.
Practice Address - Street 2:
Practice Address - City:KRUM
Practice Address - State:TX
Practice Address - Zip Code:76249
Practice Address - Country:US
Practice Address - Phone:940-482-6257
Practice Address - Fax:940-482-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX612673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184810301Medicaid
TXAMB738OtherBC BS
TX184810301Medicaid