Provider Demographics
NPI:1679588685
Name:CITY OF DICKINSON
Entity Type:Organization
Organization Name:CITY OF DICKINSON
Other - Org Name:DICKINSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-337-6261
Mailing Address - Street 1:2716 FM 517 RD E
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8615
Mailing Address - Country:US
Mailing Address - Phone:281-337-6261
Mailing Address - Fax:281-337-6190
Practice Address - Street 1:2716 FM 517 RD E
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8615
Practice Address - Country:US
Practice Address - Phone:281-337-6261
Practice Address - Fax:281-337-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800092341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00296354OtherRAILROAD MEDICARE
TXAMB818OtherBC/BS OF TEXAS
TXAMB508Medicare PIN