Provider Demographics
NPI:1679551584
Name:KING COUNTY EMS
Entity Type:Organization
Organization Name:KING COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-596-4111
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:TX
Mailing Address - Zip Code:79236-0111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:TX
Practice Address - Zip Code:79256-9998
Practice Address - Country:US
Practice Address - Phone:806-596-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1350023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX526164Medicare ID - Type Unspecified