Provider Demographics
NPI:1265447130
Name:AUBREY AREA AMBULANCE, INC
Entity Type:Organization
Organization Name:AUBREY AREA AMBULANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS LT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:LOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-365-9785
Mailing Address - Street 1:200 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-4612
Mailing Address - Country:US
Mailing Address - Phone:940-365-9785
Mailing Address - Fax:940-365-9911
Practice Address - Street 1:200 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-4612
Practice Address - Country:US
Practice Address - Phone:940-365-9785
Practice Address - Fax:940-365-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61019341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
528203OtherBC/BS OF TEXAS
TX151860701Medicaid