County of Ward
Organization Active NPI Land Ambulance · Monahans, TX
NPI 1104064807 · NPPES record last updated Jun 17, 2022
Key facts
- NPI
- 1104064807
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 238003 (TX)
- Legal business name
- COUNTY OF WARD
- Practice address
- 401 South Calvin
Monahans, TX 79756 - Phone
- (432) 943-8622
- Fax
- (432) 943-2619
- NPI assigned
- Feb 3, 2009
- Organization subpart
- No
Authorized official
- Name
- Michael Enriquez, PARAMEDIC
- Title
- EMS Director
- Phone
- (432) 943-8622
Owned or controlled facilities with NPI records 5
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 6
Practitioners 19
-
Dee A Bean, PA-C
-
Jordan Bond Cooper, C.R.N.A.
-
Suhail Sami Daye, M.D.
-
Alexandra R Fierro, PA-C
-
Jennifer Brook Hada-Ondriezek, D.P.M.
-
Manka Agnes Kwayu, PMHNP - BC
-
Ashley Loy, PA-C
-
Subodh K Mallik, M.D.
-
Subhash K Nagalla, M.D.
-
Krista Leah Powell, FNP
-
Malinda Ann Redmon, FAMILY NP
-
Henry Barasa Sirengo, N.P
-
Htin Aung Thaung, MD
-
Toni Irene White, M.D.
-
Eman Boulis, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1027775 | Ward County EMS | Certificate of waiver | Jul 8, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Ward Memorial Hospital ER Group |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Ward Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Sandhills Family Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Sandhills Family Clinic East |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090819000830 | TX | Part B Supplier - Ambulance Service Supplier | 1456261494 | Practice locations: Monahans, TX |
National Provider Directory
- Tax ID family
- Judith a Moss DO
Locations
811 E 4th St
Monahans, TX 79756
Phone (432) 943-8622
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 238003 | TX | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2074411-02 | Other | TX | MEDICAID CSHCN |
| 2074411-01 | Medicaid | TX |
Other names
- Ward County EMS
Other providers in Monahans, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.