Provider Demographics
NPI:1427036334
Name:WIMBERLEY EMERGENCY MEDICAL SERVICE SYSTEMS, INC
Entity Type:Organization
Organization Name:WIMBERLEY EMERGENCY MEDICAL SERVICE SYSTEMS, INC
Other - Org Name:WIMBERLEY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-847-2526
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-0033
Mailing Address - Country:US
Mailing Address - Phone:512-847-2526
Mailing Address - Fax:
Practice Address - Street 1:220 TWLIGHT TRAIL
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-0033
Practice Address - Country:US
Practice Address - Phone:512-847-2526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000501901Medicaid
TX000501901Medicaid