Provider Demographics
NPI:1942208020
Name:COUNTY OF KINNEY
Entity Type:Organization
Organization Name:COUNTY OF KINNEY
Other - Org Name:KINNEY COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:KINNEY COUNTY JUDGE
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLARD
Authorized Official - Middle Name:WOOD
Authorized Official - Last Name:MASSINGILL
Authorized Official - Suffix:
Authorized Official - Credentials:COUNTY JUDGE
Authorized Official - Phone:830-563-2401
Mailing Address - Street 1:PO BOX 1499
Mailing Address - Street 2:
Mailing Address - City:BRACKETTVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78832-1499
Mailing Address - Country:US
Mailing Address - Phone:830-563-9090
Mailing Address - Fax:830-563-9949
Practice Address - Street 1:401 S. ELLEN
Practice Address - Street 2:
Practice Address - City:BRACKETTVILLE
Practice Address - State:TX
Practice Address - Zip Code:78832
Practice Address - Country:US
Practice Address - Phone:830-563-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086555201Medicaid
TX504561Medicare ID - Type UnspecifiedID# FOR MEDICARE