Provider Demographics
NPI:1235169046
Name:LEFORS VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:LEFORS VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-835-2772
Mailing Address - Street 1:PO BOX 721648
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-1648
Mailing Address - Country:US
Mailing Address - Phone:713-773-4355
Mailing Address - Fax:713-773-4363
Practice Address - Street 1:107 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEFORS
Practice Address - State:TX
Practice Address - Zip Code:79054
Practice Address - Country:US
Practice Address - Phone:806-835-2772
Practice Address - Fax:806-835-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX090002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX506120Medicare PIN