Provider Demographics
NPI:1619014719
Name:NORTH BOSQUE VOLUNTEER EMS INC.
Entity Type:Organization
Organization Name:NORTH BOSQUE VOLUNTEER EMS INC.
Other - Org Name:NORTH BOSQUE EMS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THIELE
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:254-435-2070
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76665-0119
Mailing Address - Country:US
Mailing Address - Phone:254-435-2070
Mailing Address - Fax:254-435-2560
Practice Address - Street 1:200 EAST MORGAN
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:TX
Practice Address - Zip Code:76665-0119
Practice Address - Country:US
Practice Address - Phone:254-435-2070
Practice Address - Fax:254-435-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018007341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA463OtherFIRSTCARE
TX590015397OtherMEDICARE RAILROAD
TX0000AMB067OtherBLUE CROSS
TX000720501Medicaid
TX000720501Medicaid
TXA463OtherFIRSTCARE