Provider Demographics
NPI:1578698213
Name:CITY OF SUNRAY
Entity Type:Organization
Organization Name:CITY OF SUNRAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUMPAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:EMT-PARAMEDIC
Authorized Official - Phone:806-930-5791
Mailing Address - Street 1:PO BOX 180446
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-0446
Mailing Address - Country:US
Mailing Address - Phone:972-602-2060
Mailing Address - Fax:903-887-1863
Practice Address - Street 1:910 MAIN
Practice Address - Street 2:
Practice Address - City:SUNRAY
Practice Address - State:TX
Practice Address - Zip Code:79086
Practice Address - Country:US
Practice Address - Phone:806-948-4111
Practice Address - Fax:806-948-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000009301Medicaid
TXP00724454OtherRAIL ROAD
TXP00724454OtherRAIL ROAD