Provider Demographics
NPI:1265491690
Name:VEGA VOLUNTEER FIRE DEPT & AMBULANCE SERVICE
Entity Type:Organization
Organization Name:VEGA VOLUNTEER FIRE DEPT & AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-426-3492
Mailing Address - Street 1:901 S. DAVIS
Mailing Address - Street 2:
Mailing Address - City:VEGA
Mailing Address - State:TX
Mailing Address - Zip Code:79092-0530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 S. DAVIS
Practice Address - Street 2:
Practice Address - City:VEGA
Practice Address - State:TX
Practice Address - Zip Code:79092-0530
Practice Address - Country:US
Practice Address - Phone:806-426-3492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1800033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000004401Medicaid
TXP00274144OtherRAILROAD MEDICARE
TX500820Medicare ID - Type Unspecified