Organization Active NPI

County of Ward

Doing business as Ward County EMS

  • Land Ambulance
  • Monahans, TX
National Provider Identifier
1104064807
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
238003 Issued in TX
Legal business name
COUNTY OF WARD
Doing business as
Ward County EMS
Practice address
401 South Calvin
Monahans, TX 79756
Phone
(432) 943-8622
Fax
(432) 943-2619
NPI assigned
Feb 3, 2009
Last updated
Jun 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Enriquez, PARAMEDIC
Title
EMS Director
Phone
(432) 943-8622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 238003 TX Primary

Addresses

Primary practice location

401 South Calvin
Monahans, TX 79756

Mailing address

400 S Allen Ave
Monahans, TX 79756-4603
Phone (432) 943-8622

Other names 1

  • Ward County EMS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000830 TX Part B Supplier - Ambulance Service Supplier 1456261494 Practice locations: Monahans, TX

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1027775Ward County EMS401 S Calvin Ave, Monahans, TX 79756Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ward Countyward Mem Ho7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

811 E 4th St
Monahans, TX 79756
Phone (432) 943-8622

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ward Memorial Hospital ER GroupMonahans, TX, CCN 451373 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Ward Memorial HospitalMonahans, TX, CCN 45Z373 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Sandhills Family ClinicMonahans, TX, CCN 458684 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Sandhills Family Clinic EastMonahans, TX, CCN 673475 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1104064807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S ALLEN AVE",
            "city": "MONAHANS",
            "state": "TX",
            "postal_code": "797564603",
            "telephone_number": "432-943-8622",
            "fax_number": "432-943-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SOUTH CALVIN",
            "city": "MONAHANS",
            "state": "TX",
            "postal_code": "79756",
            "telephone_number": "432-943-8622",
            "fax_number": "432-943-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "ENRIQUEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "432-943-8622",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "238003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ward County EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ward County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monahans, TX

Sources for this page

Verify at the official NPI Registry.