Provider Demographics
NPI:1740219427
Name:COUNTY OF REAGAN
Entity Type:Organization
Organization Name:COUNTY OF REAGAN
Other - Org Name:BIG LAKE FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF/EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-884-3650
Mailing Address - Street 1:207 N. PLAZA
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76932
Mailing Address - Country:US
Mailing Address - Phone:325-884-3650
Mailing Address - Fax:325-884-3396
Practice Address - Street 1:207 N. PLAZA
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:TX
Practice Address - Zip Code:76932
Practice Address - Country:US
Practice Address - Phone:325-884-3650
Practice Address - Fax:325-884-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192001OtherTEXAS DSHS
TX148679701Medicaid
TX590015344OtherRAILROAD
TX501287Medicare PIN