Provider Demographics
NPI:1881676773
Name:HAMSHIRE VOLUNTARY FIRE DEPARTMENT, INC.
Entity Type:Organization
Organization Name:HAMSHIRE VOLUNTARY FIRE DEPARTMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HURYCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-243-2311
Mailing Address - Street 1:PO BOX 10245
Mailing Address - Street 2:2800 BEAUMONT AVE
Mailing Address - City:LIBERTY
Mailing Address - State:TX
Mailing Address - Zip Code:77575-7745
Mailing Address - Country:US
Mailing Address - Phone:409-243-2311
Mailing Address - Fax:409-243-2113
Practice Address - Street 1:12393 2ND STREET
Practice Address - Street 2:
Practice Address - City:HAMSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77622-9400
Practice Address - Country:US
Practice Address - Phone:409-243-2311
Practice Address - Fax:409-243-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123004341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088226801Medicaid
TX514387Medicare ID - Type Unspecified