Provider Demographics
NPI:1942372354
Name:CRAWFORD EMERGENCY MEDICAL SERVICE, INC
Entity Type:Organization
Organization Name:CRAWFORD EMERGENCY MEDICAL SERVICE, INC
Other - Org Name:CRAWFORD EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-486-2101
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76638-0341
Mailing Address - Country:US
Mailing Address - Phone:254-486-2101
Mailing Address - Fax:
Practice Address - Street 1:245 NORTH AVENUE F
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:TX
Practice Address - Zip Code:76638
Practice Address - Country:US
Practice Address - Phone:254-486-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300158341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB793OtherBLUE CROSS BLUE SHIELD
TX514827Medicare ID - Type Unspecified