Provider Demographics
NPI:1467555730
Name:MENARD EMERGENCY SERVICES, INC.
Entity Type:Organization
Organization Name:MENARD EMERGENCY SERVICES, INC.
Other - Org Name:MENARD EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-396-4626
Mailing Address - Street 1:PO BOX 1261
Mailing Address - Street 2:
Mailing Address - City:MENARD
Mailing Address - State:TX
Mailing Address - Zip Code:76859-1261
Mailing Address - Country:US
Mailing Address - Phone:325-396-4626
Mailing Address - Fax:325-396-2802
Practice Address - Street 1:401 BEVANS ST
Practice Address - Street 2:
Practice Address - City:MENARD
Practice Address - State:TX
Practice Address - Zip Code:76859-1261
Practice Address - Country:US
Practice Address - Phone:325-396-4626
Practice Address - Fax:325-396-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1640033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001273-01Medicaid
TX506732Medicare PIN