Provider Demographics
NPI:1306840079
Name:SAN SABA COUNTY EMERGENCY MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:SAN SABA COUNTY EMERGENCY MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PARAMEDIC
Authorized Official - Phone:325-372-6016
Mailing Address - Street 1:607 E WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:SAN SABA
Mailing Address - State:TX
Mailing Address - Zip Code:76877-4702
Mailing Address - Country:US
Mailing Address - Phone:325-372-6016
Mailing Address - Fax:325-372-3809
Practice Address - Street 1:607 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN SABA
Practice Address - State:TX
Practice Address - Zip Code:76877-4702
Practice Address - Country:US
Practice Address - Phone:325-372-6016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2060023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0882185-01Medicaid
TX0882185-01Medicaid