Provider Demographics
NPI:1689652588
Name:BANDERA COUNTY
Entity Type:Organization
Organization Name:BANDERA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:REED
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-796-4282
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:BANDERA
Mailing Address - State:TX
Mailing Address - Zip Code:78003-0005
Mailing Address - Country:US
Mailing Address - Phone:830-796-4282
Mailing Address - Fax:
Practice Address - Street 1:1106 MAIN ST
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003-0005
Practice Address - Country:US
Practice Address - Phone:830-796-4282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086488601Medicaid
TX504063Medicare ID - Type UnspecifiedAMBULANCE