Provider Demographics
NPI:1053644625
Name:DILLEY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:DILLEY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-965-2034
Mailing Address - Street 1:211 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:DILLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78017-3819
Mailing Address - Country:US
Mailing Address - Phone:830-965-2034
Mailing Address - Fax:830-965-1769
Practice Address - Street 1:211 W MILLER ST
Practice Address - Street 2:
Practice Address - City:DILLEY
Practice Address - State:TX
Practice Address - Zip Code:78017-3819
Practice Address - Country:US
Practice Address - Phone:830-965-2034
Practice Address - Fax:830-965-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport