Provider Demographics
NPI:1639684988
Name:CITY OF SAINT JO
Entity Type:Organization
Organization Name:CITY OF SAINT JO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-995-2463
Mailing Address - Street 1:PO BOX 610562
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-0562
Mailing Address - Country:US
Mailing Address - Phone:877-602-2060
Mailing Address - Fax:800-978-8590
Practice Address - Street 1:100 N LINE
Practice Address - Street 2:
Practice Address - City:SAINT JO
Practice Address - State:TX
Practice Address - Zip Code:76265
Practice Address - Country:US
Practice Address - Phone:940-995-2463
Practice Address - Fax:800-978-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1690023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169002OtherLICENSE