Provider Demographics
NPI:1649362096
Name:CITY OF ENNIS
Entity type:Organization
Organization Name:CITY OF ENNIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-875-1234
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75110-0220
Mailing Address - Country:US
Mailing Address - Phone:972-875-1234
Mailing Address - Fax:972-875-4615
Practice Address - Street 1:206 S DALLAS ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4747
Practice Address - Country:US
Practice Address - Phone:972-875-1234
Practice Address - Fax:972-875-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700005341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086441501Medicaid
TX503777Medicare ID - Type Unspecified