City of Earth

Organization Active NPI Ambulance · Earth, TX

NPI 1255339347 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1255339347
Entity type
Organization (NPI type 2)
Primary specialty
Ambulance 341600000X
License
140006 (TX)
Legal business name
CITY OF EARTH
Practice address
202 East Main
Earth, TX 79031-0010
Phone
(806) 257-3415
NPI assigned
Jul 12, 2005
Organization subpart
No

Authorized official

Name
Mr. J. Allen Gover
Title
Mayor
Phone
(806) 257-2111

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20121108000251 TX Part B Supplier - Ambulance Service Supplier 9739330374 Practice locations: Earth, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X
Ambulance 341600000X 140006 TX Yes

Addresses

Primary practice location

202 East Main
Earth, TX 79031-0010

Mailing address

P.O. Box 10
Earth, TX 79031-0010
Phone (806) 257-2111

Other identifiers

IdentifierTypeStateIssuer
000118201MedicaidTX

Other providers in Earth, TX

All providers in Earth, TX · Ambulance in Texas

Sources for this page

Verify at the official NPI Registry.