Provider Demographics
NPI:1740255934
Name:WELLINGTON EMS, INC.
Entity type:Organization
Organization Name:WELLINGTON EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC/TREAS
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-447-1417
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:79095-0544
Mailing Address - Country:US
Mailing Address - Phone:806-447-1417
Mailing Address - Fax:806-447-2635
Practice Address - Street 1:806 EAST AVE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:TX
Practice Address - Zip Code:79095-2712
Practice Address - Country:US
Practice Address - Phone:806-447-1417
Practice Address - Fax:806-447-2635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX044001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX528017Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.