Provider Demographics
NPI:1043300403
Name:WASKOM VOLUNTEER FIRE DEPARTMENT AND EMS SERVICES INC
Entity Type:Organization
Organization Name:WASKOM VOLUNTEER FIRE DEPARTMENT AND EMS SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MASCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING SPECIALIST
Authorized Official - Phone:903-473-0927
Mailing Address - Street 1:PO BOX 1757
Mailing Address - Street 2:
Mailing Address - City:WASKOM
Mailing Address - State:TX
Mailing Address - Zip Code:75692-1757
Mailing Address - Country:US
Mailing Address - Phone:903-473-0927
Mailing Address - Fax:877-687-7471
Practice Address - Street 1:185 EAST TEXAS AVE
Practice Address - Street 2:
Practice Address - City:WASKOM
Practice Address - State:TX
Practice Address - Zip Code:75692-1757
Practice Address - Country:US
Practice Address - Phone:888-473-0920
Practice Address - Fax:832-778-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0000003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000400401Medicaid
TX590012518OtherMEDICARE RAILROAD
TX590012518OtherMEDICARE RAILROAD
TX590012518OtherMEDICARE RAILROAD
TX=========OtherCOMMERCIAL