Provider Demographics
NPI:1023086063
Name:NORTH BLANCO COUNTY EMERGENCY MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:NORTH BLANCO COUNTY EMERGENCY MEDICAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, LP
Authorized Official - Phone:830-868-7834
Mailing Address - Street 1:PO BOX 557
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78636-0557
Mailing Address - Country:US
Mailing Address - Phone:830-868-7834
Mailing Address - Fax:830-868-9234
Practice Address - Street 1:105 BILL WATSON DRIVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TX
Practice Address - Zip Code:78636-0557
Practice Address - Country:US
Practice Address - Phone:830-868-7834
Practice Address - Fax:830-868-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0160023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000076201Medicaid
TX505732Medicare ID - Type UnspecifiedAMBULANCE