Provider Demographics
NPI:1780605311
Name:MARBLE FALLS AREA EMERGENCY MEDICAL SERVICES INC
Entity type:Organization
Organization Name:MARBLE FALLS AREA EMERGENCY MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-693-7277
Mailing Address - Street 1:609 INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4739
Mailing Address - Country:US
Mailing Address - Phone:830-693-7277
Mailing Address - Fax:830-693-3644
Practice Address - Street 1:609 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4739
Practice Address - Country:US
Practice Address - Phone:830-693-7277
Practice Address - Fax:830-693-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX506835OtherBC/BS OF TEXAS
P00172965OtherRAILROAD MEDICARE
TX000136401Medicaid
TX1780605311OtherTRICARE
P00172965OtherRAILROAD MEDICARE