Provider Demographics
NPI:1790911774
Name:ALPHA RESCUE EMS
Entity Type:Organization
Organization Name:ALPHA RESCUE EMS
Other - Org Name:SAME
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:WILLARD
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:409-385-3757
Mailing Address - Street 1:222 E DURDIN DR
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-6400
Mailing Address - Country:US
Mailing Address - Phone:409-385-8705
Mailing Address - Fax:409-385-8707
Practice Address - Street 1:222 E DURDIN DR
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-6400
Practice Address - Country:US
Practice Address - Phone:409-385-8705
Practice Address - Fax:409-385-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10004533416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport