Provider Demographics
NPI:1225006786
Name:CITY OF FREEPORT
Entity Type:Organization
Organization Name:CITY OF FREEPORT
Other - Org Name:FREEPORT FIRE/EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:BILLYWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-233-2111
Mailing Address - Street 1:131 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:77541-5909
Mailing Address - Country:US
Mailing Address - Phone:979-233-2111
Mailing Address - Fax:979-233-4103
Practice Address - Street 1:131 E 4TH ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:TX
Practice Address - Zip Code:77541-5909
Practice Address - Country:US
Practice Address - Phone:979-233-2111
Practice Address - Fax:979-233-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000715501Medicaid
LA1635740Medicaid
590014582OtherRAILROAD MEDICARE
TXAMB061Medicare ID - Type Unspecified
LA1635740Medicaid