Provider Demographics
NPI:1376681353
Name:CITY OF HURST
Entity Type:Organization
Organization Name:CITY OF HURST
Other - Org Name:CITY OF HURST TEXAS, CITY OF HURST AMBULANCE, CITY OF HURST EAS
Other - Org Type:Other Name
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARUTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-788-7027
Mailing Address - Street 1:1505 PRECINCT LINE RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3302
Mailing Address - Country:US
Mailing Address - Phone:817-788-7000
Mailing Address - Fax:214-741-1412
Practice Address - Street 1:1505 PRECINCT LINE RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3302
Practice Address - Country:US
Practice Address - Phone:817-788-7000
Practice Address - Fax:214-741-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3002343416L0300X
TX2200713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX590084030OtherRAILROAD MEDICARE
TX501188OtherBLUE CROSS BLUE SHIELD
TX000752801Medicaid
TX590084030OtherRAILROAD MEDICARE