City of Georgetown

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1000943 Issued in TX

Legal business name

CITY OF GEORGETOWN

Practice address

3500 D B Wood Rd
Georgetown, TX 78628-7222

Phone

(512) 930-6104

Fax

(512) 930-3613

NPI assigned

Aug 11, 2015

Organization subpart

No

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

Authorized official

Name

John Sullivan

Title

Fire Chief

Phone

(512) 930-3611

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1265808430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409",
            "address_2": "3500 D.B. WOOD RD.",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786270409",
            "telephone_number": "512-930-6104",
            "fax_number": "512-930-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 D B WOOD RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786287222",
            "telephone_number": "512-930-6104",
            "fax_number": "512-930-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF GEORGETOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "512-930-3611"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": "1000943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.