Provider Demographics
NPI:1477794931
Name:TRI-STATE EMS INC
Entity Type:Organization
Organization Name:TRI-STATE EMS INC
Other - Org Name:TRI STATE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CELESTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-334-8303
Mailing Address - Street 1:2156 W NORTHWEST HWY
Mailing Address - Street 2:309
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-4221
Mailing Address - Country:US
Mailing Address - Phone:214-334-8303
Mailing Address - Fax:940-626-2063
Practice Address - Street 1:2156 W NORTHWEST HWY
Practice Address - Street 2:309
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4221
Practice Address - Country:US
Practice Address - Phone:214-334-8303
Practice Address - Fax:940-626-2063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000231341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherBLUE CROSS & BLUE SHIELD OF TEXAS