Provider Demographics
NPI:1912005166
Name:COUNTY OF SUTTON
Entity Type:Organization
Organization Name:COUNTY OF SUTTON
Other - Org Name:SUTTON COUNTY AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY JUDGE
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-387-2711
Mailing Address - Street 1:PO BOX 1067
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:TX
Mailing Address - Zip Code:76950-1067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 E 3RD ST
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:TX
Practice Address - Zip Code:76950-6439
Practice Address - Country:US
Practice Address - Phone:325-387-5132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2188001341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086560201Medicaid
TX086560201Medicaid
=========OtherTAX ID