Provider Demographics
NPI:1831229384
Name:JUSTIN VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:JUSTIN VOLUNTEER FIRE DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-395-0546
Mailing Address - Street 1:PO BOX 700847
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-0847
Mailing Address - Country:US
Mailing Address - Phone:972-250-2023
Mailing Address - Fax:972-250-2086
Practice Address - Street 1:310 N SEALY AVE
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247
Practice Address - Country:US
Practice Address - Phone:940-648-2561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX061017341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000745201Medicaid
TXAMB542OtherBC BS OF TX
TX590014158OtherRR MEDICARE
TXAMB117OtherBCBS
TXAMB117OtherBCBS
TXAMB117OtherBCBS