Provider Demographics
NPI:1235219114
Name:MCGREGOR VOLUNTEER EMERGENCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:MCGREGOR VOLUNTEER EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:TARBET
Authorized Official - Suffix:JR
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:254-840-2528
Mailing Address - Street 1:P.O. BOX 237
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-0237
Mailing Address - Country:US
Mailing Address - Phone:254-840-2528
Mailing Address - Fax:254-840-4362
Practice Address - Street 1:404 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MCGREGOR
Practice Address - State:TX
Practice Address - Zip Code:76657-0237
Practice Address - Country:US
Practice Address - Phone:254-840-2528
Practice Address - Fax:254-840-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1550153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX590012855OtherRAILROAD MEDICARE
TX506346OtherBLUE CROSS/BLUE SHIELD
TX0001042-01Medicaid
TX590012855OtherRAILROAD MEDICARE