Provider Demographics
NPI:1790769743
Name:TRI COUNTY EMERGENCY MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:TRI COUNTY EMERGENCY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-776-0025
Mailing Address - Street 1:PO BOX 1378
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-1378
Mailing Address - Country:US
Mailing Address - Phone:361-776-0025
Mailing Address - Fax:361-776-3560
Practice Address - Street 1:2565 1ST ST
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-5931
Practice Address - Country:US
Practice Address - Phone:361-776-0025
Practice Address - Fax:361-776-3560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
TX2050093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000144801Medicaid
TX000144801Medicaid