Provider Demographics
NPI:1477537223
Name:WILLIAMS A AMBULANCE, INC.
Entity Type:Organization
Organization Name:WILLIAMS A AMBULANCE, INC.
Other - Org Name:STAT CARE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-833-3834
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77704-0552
Mailing Address - Country:US
Mailing Address - Phone:409-833-3834
Mailing Address - Fax:409-833-2060
Practice Address - Street 1:3863 STAGG DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3717
Practice Address - Country:US
Practice Address - Phone:409-833-3834
Practice Address - Fax:409-833-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800018341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGTPA1OtherTEXAN PLUS
TX182096700OtherUS DEPT LABOR WC
TX000367501Medicaid
TX1430121OtherTEXAS HEALTHSPRING
TX4625OtherUSFHP TEXAS
TX514211OtherBLUE CROSS BLUE SHIELD
TX590008601OtherMEDICARE RR
TX80705OtherGREAT WEST
TXGTPA1OtherENCORE ENCORE
TXGTPA1OtherENCORE ENCORE
TX4625OtherUSFHP TEXAS