Provider Demographics
NPI:1437190519
Name:LEVELLAND EMS CORP
Entity Type:Organization
Organization Name:LEVELLAND EMS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERRIS
Authorized Official - Middle Name:ESSID
Authorized Official - Last Name:SHAHEEN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:806-894-8855
Mailing Address - Street 1:809 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-5422
Mailing Address - Country:US
Mailing Address - Phone:806-894-8855
Mailing Address - Fax:806-894-7097
Practice Address - Street 1:809 11TH ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-5422
Practice Address - Country:US
Practice Address - Phone:806-894-8855
Practice Address - Fax:806-894-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110004341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000278401Medicaid
TX104409100OtherFIRST CARE
TX000278401Medicaid