Provider Demographics
NPI:1356320691
Name:ACUTE CARE EMS, INC.
Entity Type:Organization
Organization Name:ACUTE CARE EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAYNES
Authorized Official - Middle Name:FITZGERALD
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-272-6842
Mailing Address - Street 1:5017 STATE HIGHWAY 7 W
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835-7808
Mailing Address - Country:US
Mailing Address - Phone:281-272-6842
Mailing Address - Fax:281-591-0102
Practice Address - Street 1:5017 STATE HIGHWAY 7 W
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-7808
Practice Address - Country:US
Practice Address - Phone:281-272-6842
Practice Address - Fax:281-591-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165010301Medicaid
TXAMB366Medicare ID - Type UnspecifiedPROVIDER NUMBER