Provider Demographics
NPI:1336163039
Name:FARWELL EMS
Entity Type:Organization
Organization Name:FARWELL EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD BILLER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LINDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-493-0953
Mailing Address - Street 1:3005 S LAMAR BLVD
Mailing Address - Street 2:SUITE D109-372
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8864
Mailing Address - Country:US
Mailing Address - Phone:512-493-0953
Mailing Address - Fax:
Practice Address - Street 1:100 9TH STREET
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:TX
Practice Address - Zip Code:79325
Practice Address - Country:US
Practice Address - Phone:806-481-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1850013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB039Medicare ID - Type Unspecified