Provider Demographics
NPI:1346499902
Name:PECOS COUNTY
Entity Type:Organization
Organization Name:PECOS COUNTY
Other - Org Name:PECOS COUNTY EMERGENCY MEDICAL SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY JUDGE, PECOS COUNTY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-336-2792
Mailing Address - Street 1:103 W CALLAGHAN ST
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735-7101
Mailing Address - Country:US
Mailing Address - Phone:432-336-3062
Mailing Address - Fax:432-336-4645
Practice Address - Street 1:310 W 5TH STREET
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735
Practice Address - Country:US
Practice Address - Phone:432-336-3062
Practice Address - Fax:432-336-4645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001893416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport