Provider Demographics
NPI:1942395199
Name:WINNIE-STOWELL VOLUNTEER EMERGENCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:WINNIE-STOWELL VOLUNTEER EMERGENCY MEDICAL SERVICES
Other - Org Name:WINNIE-STOWELL VOLUNTEER EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-791-4801
Mailing Address - Street 1:PO BOX 691363
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1363
Mailing Address - Country:US
Mailing Address - Phone:281-397-0397
Mailing Address - Fax:281-397-6934
Practice Address - Street 1:249 BROADWAY
Practice Address - Street 2:
Practice Address - City:WINNIE
Practice Address - State:TX
Practice Address - Zip Code:77665
Practice Address - Country:US
Practice Address - Phone:409-296-9627
Practice Address - Fax:409-296-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX036003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015404OtherRAILROAD
TX0882227-01Medicaid
590015404OtherRAILROAD
TX513617Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER