Provider Demographics
NPI:1770709487
Name:FIRST RESPONSE EMS
Entity type:Organization
Organization Name:FIRST RESPONSE EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BACCO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-517-4593
Mailing Address - Street 1:PO BOX 850408
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-0408
Mailing Address - Country:US
Mailing Address - Phone:972-289-4645
Mailing Address - Fax:972-289-4611
Practice Address - Street 1:2611 N BELT LINE RD
Practice Address - Street 2:SUITE 138
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9301
Practice Address - Country:US
Practice Address - Phone:972-289-4645
Practice Address - Fax:972-289-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX057101341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10011110OtherAMERIGROUP
TX7459878OtherCIGNA
TXP00101522OtherRAILROAD MEDICARE
TX10011110OtherAMERIGROUP