Provider Demographics
NPI:1609191808
Name:RURAL AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:RURAL AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-855-6311
Mailing Address - Street 1:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-0907
Mailing Address - Country:US
Mailing Address - Phone:361-798-2200
Mailing Address - Fax:361-798-2205
Practice Address - Street 1:1676 US HIGHWAY 90A W
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-5733
Practice Address - Country:US
Practice Address - Phone:361-798-2200
Practice Address - Fax:361-798-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10004073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000407OtherAMBULANCE LICENSE NUMBER